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Blue Zones are regions of the world where, it is claimed, a higher than usual number people live much longer than average. The term first appeared in his November 2005 National Geographic magazine cover story, "The Secrets of a Long Life". Five "Blue Zones" have been posited: Okinawa (Japan); Sardinia (Italy); Nicoya (Costa Rica); Icaria (Greece); and among the Seventh-day Adventists in Loma Linda, California, based on evidence showing why these populations live healthier and longer lives than others.
The concept grew out of demographic work done by Gianni Pes and Michel Poulain outlined in the Journal of Experimental Gerontology, who identified Sardinia's Nuoro province as the region with the highest concentration of male centenarians. As the two men zeroed in on the cluster of villages with the highest longevity, they drew concentric blue circles on the map and began referring to the area inside the circle as the "Blue Zone". Together with demographers Pes and Poulain, Buettner broadened the term, applying it to validated longevity areas of Okinawa, Japan and among the Seventh-day Adventists in Loma Linda, California. Buettner and Poulain, under the aegis of National Geographic, then identified and validated longevity hotspots in Nicoya, Costa Rica and Icaria, Greece. Buettner mentions in his book that people are doing the right things for long enough, and avoiding the wrong things," there are four main things that people in those zones do in order to live healthier and longer lives, and they consist of moving regularly, which does not comprise of exercise alone, but doing daily energy burst habits throughout the day. The second aspect is living with purpose, having a reason to get up every day, and living with perspective. The third aspect of blue zone populations is the social support they receive from friends and family allowing them to move through life outcomes more smoothly. Fourth but not least is the concept that most still do not understand, which is making the "healthy choice the easy choice", and not just an option. Living by these four concepts brings longevity and mental and physical problems to one's life and society.
The five regions that are identified in the book The Blue Zones: Lessons for Living Longer from the People Who've Lived the Longest are:
- Sardinia, Italy (particularly Ogliastra, Barbagia of Ollolai, and Barbagia of Seulo): One team of demographers found a hot spot of longevity in mountain villages where a substantial proportion of men reach 100. In particular, a village called Seulo, located in the Barbagia of Seulo, holds the record of 20 centenarians from 1996 to 2016, that confirms it is "the place where people live the longest in the world".
- The islands of Okinawa, Japan: Another team examined a group that is among the longest-lived on Earth.
- Loma Linda, California: Researchers studied a group of Seventh-day Adventists who rank among North America's longest-lived people.
- Nicoya Peninsula, Costa Rica: The peninsula was the subject of research on a Quest Network expedition which began on January 29, 2007.
- Icaria, Greece: An April 2009 study on the island of Icaria uncovered the location with the highest percentage of 90-year-olds on the planet, where nearly 1 out of 3 people make it to their 90s. Furthermore, Icarians "have about 20 percent lower rates of cancer, 50 percent lower rates of heart disease and almost no dementia."
Residents of these places produce a high rate of centenarians, suffer a fraction of the diseases that commonly kill people in other parts of the developed world, and enjoy more years of good health.
The people inhabiting Blue Zones share common lifestyle characteristics that contribute to their longevity. The Venn diagram highlights the following six shared characteristics among the people of Okinawa, Sardinia, and Loma Linda Blue Zones:[failed verification] Though not a lifestyle choice, they live as isolated populations with related gene pool.
- Family – put ahead of other concerns
- Less smoking
- Semi-vegetarianism – the majority of food consumed is derived from plants
- Constant moderate physical activity – an inseparable part of life
- Social engagement – people of all ages are socially active and integrated into their communities
- Legumes – commonly consumed
In his book, Buettner provides a list of nine lessons, covering the lifestyle of people who reside in blue zones:
- Moderate, regular physical activity.
- Life purpose.
- Stress reduction.
- Moderate caloric intake.
- Plant-based diet.
- Moderate alcohol intake, especially wine.
- Engagement in spirituality or religion.
- Engagement in family life.
- Engagement in social life.
Based on research results in the fields of biogerontology, epigenetics and naturopathy, the term Blue Zones is also used for areas whose native flora grows under special conditions and can effectively counteract the aging process. Such mostly high-altitude areas are located in Nepal, Bhutan, Tibet or China.  The Swiss research group Bluezones in cooperation with the Forschungsgruppe Haslberger of the University of Vienna focuses on secondary plant substances from such areas, which could have a use in the area of anti-aging, neurodegenerative diseases and geriatric diseases. In 1998, the Swiss group dealt with the eating habits of the population of Yuzurihara, where the inhabitants grew very old with the best quality of life. Longevity regions are also being studied in China. Another research group of the University of California in collaboration with the University of Rome La Sapienza is investigating temporal bluezones in Italy outside Sardinia.
A 2019 preprint study found that the introduction of birth certificates reduces the number of claimed super-centenarians by up to 85%, suggesting that the apparent number of supercentenarians in Blue Zones may owe more to poor record-keeping, and fraud, than to longevity.
A study of claimed longevity in Okinawa was unable to verify whether or not people there were as old as they claimed because many records did not survive WWII. More recent data has shown that life expectancy in Okinawa is no longer exceptional when compared to the rest of Japan: "male longevity is now ranked 26th among the 47 prefectures of Japan.
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