Life in a “Blue Zone”: Reflections on Sardinia
Today’s blog is a departure from previous ones. Over the last couple of years, I’ve spent quite a long time in Sardinia, an island famed for being home to some unusually long-lived people. Some of the early work showing this was done by Gianni Pes and Michel Poulain as part of a National Geographic project. Having identified Nuoro in Sardinia as an area home to some strikingly old men, they drew concentric blue circles on a map to highlight where these people clustered and began referring to the regions as “Blue Zones”. Dan Buettner, a charismatic storyteller and explorer, has since done a huge amount to popularise the notion of Blue Zones, and more recently identified Zones include Icaria (Greece), the Nicoya Peninsula (Costa Rica), Loma Linda (California), and Okinawa (Japan).
Since the analyses that first flagged the Blue Zones, scientists have been trying to understand the bases of the exceptional longevity of people in these places, focusing on everything from genetics to lifestyle. At the same time, these longevity hotspots have caught the imagination of the public and an entire Blue Zone industry has emerged, comprising books, community programmes, an app, tourism centered on visiting these places, and more. Blue Zones has become a brand.
What’s interesting is that the whole Blue Zones concept is a bit contentious. As one example of this, a couple of years ago Saul Newman from the Australian National University published an analysis of data from the US and Italy showing the following:
- When state-specific birth certificates were introduced in the US, there was a sudden drop in the apparent number of people living very long lives.
- In Italy, the regions with the longest-lived people have low average life expectancies, poor education, and low incomes, suggesting that the apparently impressively old people in these places might not have accurate birth certificates.
Newman’s curt and astute analysis is a page turner, and I wasn’t exactly blown away by Buettner’s brief reply.
I want to make it clear that I have no dog in this fight, but I’ve always been skeptical of the notion of Blue Zones and the less-than-systematic ways they’ve sometimes been studied. For one, to avoid bias, researchers need to use untargeted methods to unveil the determinants of exceptional longevity, and the variety of these determinants and complexity of interactions between them is both mind boggling and beyond our current grasp, in my opinion. Consider also how hard it is to try to retrospectively figure out the numerous important variables that affected the health trajectories of now-elderly people, variables that not only shaped their own lives but also those of previous generations. And needless to say, the Sardinia in which these champions of successful ageing now live is surely a far cry from that in which they spent their early lives.
With those caveats out the way, Ali (CEO of Resilient Nutrition) suggested I share my (unscientific, subjective) assessment of whether the rest of us can learn anything from life in Sardinia.
I'll state my bias up front: I adore Sardinia. It’s beautiful, the people are generally very friendly, the food is yummy, the climate is approximately 102 times better than its English counterpart, and the culture is interesting. But with that caveat aside, I do think there’s indeed a lot the rest of us can learn from the Sardinians as we strive to thrive in our modern world.
Why this Blue Zone might be an unusually healthy place to live
The list below is by no means comprehensive, but hopefully it gets at the essence of why Sardinia seems so special to me.
The Sardinians have strong senses of identity, community, and purpose
In my experience, the Sardinian people do not identify as being Italian. Related to this, many languages are spoken locally within even small regions of an already-small island.
No kidding: I stumbled on this graffiti while walking to the gym between writing the first and second halves of this blog.
Sardinians care about their island, which is evident in how clean the streets are. Sicily, by comparison, has very poor waste disposal in parts – just go to the outskirts of Palermo. Tangentially, the contrast between Sardinia and Sicily is interesting in many ways, for while the islands aren't far apart and share many features (climate, etc), they differ greatly in some respects.
The Sardinian people also seem to be a very tight-knit bunch. I realise I'm romanticising life in Sardinia, but it’s common to see groups of locals in their 60s and 70s hanging out at the beach and playing bocce ball (what the French call pétanque) as the sun sets.
Sardinians are chatty too, and small talk is the norm. If you speak the language, it’s hard to imagine being lonely here, and the significance of this is that it's clear that loneliness potently increases risk of various ailments and premature mortality.
La Pelosa: just another one of the hundreds of dreamy Sardinian beaches.
The beach exemplifies how the natural environment here facilitates human interaction, but the built one does too. Right now I’m in Alghero, a town on the West coast of Sardinia (Nuoro is near the east coast), and many of the public benches here are arranged in semi circles, encouraging interpersonal interaction.
An ideal spot to catch up with some old pals.
Next, one of the points made by Newman is that historically crime is rife in some Blue Zones, including Sardinia, I can sincerely say that one of the most striking things about Alghero is how safe it feels. During my time here, I haven’t seen a single fight between people - not even a verbal spat - and unlike many places in Europe (England, ahem) there’s practically no booze-catalysed hooliganism.
All of this contributes to the sense that Sardinia is a low-stress place to be, which is reinforced by seemingly-minor but probably-meaningful attributes, such as the fact that pedestrians always seem to have right of way, and the only people who ever seem to be in a rush are tourists (guilty as charged). And while I don't know how long this has been the case for, the buildings in much of Sardinia have the best shutters I've ever used - they seem to eliminate every photon trying to enter from outside. Coupled with quiet streets at night, this means many buildings have excellent sleeping environments too.
The environment encourages physical activity
The claimed Blue Zones tend to be near the sea but set in the hills. This attribute promotes physical activity, and I’ve previously touched on the fact that breaking up your day with even brief bouts of activity supports many aspects of health. Much of Sardinia is eminently walkable, with inviting streets and scenic paths winding by beaches and through hills. There are also excellent cycling routes and areas designed to be used for exercise (my favourite is the one behind Maria Pia beach in Alghero). There doesn’t seem to be much of the kind of balls-to-the-wall exercise prevalent in some countries, although there are a few well-equipped gyms and sporting facilities.
Importantly, Sardinia is naturally gorgeous, and the temperate climate is conducive to getting outside to experience the vast range of benefits conferred by spending time in nature… it might not be a coincidence that the supposed Blue Zones aren’t far from the equator. The land is also well preserved – the locals are careful about litter, and my impression is that the Sardinian people are particular about waste disposal and recycling.
Sardinians source much of their food locally and eat in line with the seasons
Honestly, I think the way people eat in Sardinia is unremarkable compared to many other Mediterranean areas. They largely eat what you’d expect them to eat, including quite a few processed foods - pasta, bread, pizza, gelato, nougat, etc. They do get through lots of fruits (tomatoes, olives, etc), veg (courgettes, etc), nuts, and coffee though.
Sardinia is also renowned for producing some terrific wines - reds, especially - and I know Buettner and co have noted that sharing a glass of wine is a key means by which Sardinians unwin(e)d.
There’s a huge (excessive) amount of noise made about people in the Blue Zones living on almost-exclusively “plant-based” diets, but my guess is this is both overstated and a red herring. First, Sardinians eat a LOT of sheep’s cheese – pecorino is a staple and has been for a long time. And like other parts of Italy, they’re partial to a strong sausage (don’t be a child) and seafood too. Next, even if a large proportion of the mass and energy of their nutrition comes from plants, this is to be expected given that Sardinia’s not far from the equator (plants grow well here), and it doesn’t mean that you should follow this pattern, especially if you haven’t had much success on a plant-rich diet and/or your ancestors come from higher latitudes. We’ll have to come back to the divisive subject of meat intake and health another time, but suffice it to say that various animal foods are among the most if not the most nutrient-dense foods on the planet.
Pecorino cheese (AKA Sardinian Viagra) at the weekly market.
So is anything notable about how Sardinians eat?
Maybe, but if there is then it’s probably the punchline you’d expect: They source a lot of their food locally (the farmer’s market here is always heaving) and therefore eat with the seasons. There just aren't many fast-food outlets. And the locals aren't prone to extremes – I can’t recall ever seeing someone who’d had way too much to drink, and it’s not exactly hard to source such people back in England. These aspects of how Sardinians eat are in keeping with what we promote in our free nutrition e-book.
A common thread?
If there’s a common thread that runs through some of the wellbeing-boosting aspects of life in Sardinia, it might well be that the natural choice is often the healthy choice because of the environment – being active to enjoy the beautiful landscape, picking up foods that happen to be sourced locally, and so on. In contrast, in many other parts of the world, opting for things that support our bodies requires concerted effort and willpower.
Sardinia is changing. Not only is the built environment morphing, the natural world is too. This summer, fires scorched parts of the island as temperatures approached 50 °C. As current forecasts of climate change in years to come range from concerning to terrifying, natural disasters are likely to affect the island more and more. While I'm optimistic we can all somehow align our behaviours to minimise such repercussions, doing so is a tall order.
I only mention this to note that, even if Sardinia was once or even currently is a bastion of exceptional wellbeing, it might not stay that way. The reality is that the map of the places that are true Blue Zones is dynamic, continuing to shift as certain regions are displaced by others.
Nevertheless, I believe that regardless of whether Sardinia is a legitimate Blue Zone, us non-Sardinians have a lot to learn from Sardinian people about how to live a long, happy life.