What Is the Blue Zone Diet?

It’s hard to keep up with all the diets out there. Atkins, Mediterranean, Paleo and many others claim their eating plan is the best for health, fitness, weight control and longevity. Another claimant you may have heard of is the Blue Zone diet.

Blue Zones are regions of the world where the diet’s creator, Dan Buettner, claims people live much longer than average. The term first appeared in a November 2005 National Geographic magazine cover story, “The Secrets of a Long Life.” Buettner, a National Geographic Fellow, identified five regions as “Blue Zones” (a term he trademarked): Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Icaria, Greece; and Loma Linda/Seventh-day Adventists, California.

The concept grew out of demographic work done by researchers who identified 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,'” says Elizabeth DeRobertis, a registered dietitian with Scarsdale Medical Group, an affiliate of White Plains Hospital in New York. Working with those demographers, and under the aegis of the National Geographic Society, Buettner applied the term to the four other validated longevity areas.

“The people inhabiting Blue Zones share common lifestyle characteristics that contribute to their longevity,” DeRobertis says. The data were intriguing enough that the oncologists in her medical group at White Plains Hospital asked her to research it and present her findings in a continuing education program for other physicians. “There may be some flaws in the data that showed that people lived to 110. (But) it is definitely worth a look, and makes sense to see if we can make some of these modifications in our lifestyle,” she says.

[Read: What Are the Secrets to Aging Well?]

Lifestyle Characteristics

DeRobertis found that, according to the diet’s creators, the people inhabiting Blue Zones share common lifestyle characteristics that contribute to their longevity.

Family. Put family ahead of other concerns.

Semi-vegetarianism. The majority of food consumed is derived from plants.

Constant moderate physical activity. This is an inseparable part of life.

Social engagement. People of all ages are socially active and integrated into their communities.

Legumes: This is one food that is commonly consumed.

Buettner offers nine lifestyle “lessons” from Blue Zones people:

1. Moderate, regular physical activity.

2. Life purpose.

3. Stress reduction.

4. Moderate caloric intake.

5. Plant-based diet.

6. Moderate alcohol intake, especially wine.

7. Engagement in spirituality or religion.

8. Engagement in family life.

9. Engagement in social life.

“One thing common to Blue Zones is that those who live there primarily eat a 95% plant-based diet,” DeRobertis says. “Although most groups are not strict vegetarians, they only tend to eat meat around five times per month.” That jibes with many large studies showing that avoiding meat can significantly reduce the risk of death from heart disease, cancer and many other causes.

[SEE: Plant-Based Diet Ideas.]

Foods in the Blue Zone Diet

The Blue Zone diet includes:

Fruits and vegetables. “They’re a great source of fiber and many different vitamins and minerals,” DeRobertis says. Eating more than five servings of fruits and vegetables a day can significantly reduce your risk of heart disease, cancer and death.

Legumes. Legumes include beans, peas, lentils and chickpeas, and they are all rich in fiber and protein. “A number of studies have shown that eating legumes is associated with lower mortality,” DeRobertis says.

Whole grains. A high intake of whole grains, which are also rich in fiber, can reduce blood pressure and is associated with reduced colorectal cancer and death from heart disease.

Nuts. “Nuts are great sources of fiber, protein and polyunsaturated and monounsaturated fats,” DeRobertis says. “Combined with a healthy diet, they’re associated with reduced mortality and may even help reverse metabolic syndrome.”

Fish. Often eaten in Icaria and Sardinia, fish is a good source of omega-3 fats, which are important for heart and brain health.

Blue Zones people also follow reduced calorie intake and fasting. Long-term calorie restriction may help longevity, DeRobertis says. “A large, 25-year study in monkeys found that eating 30% fewer calories than normal led to a significantly longer life. Studies in the Okinawans suggest that before the 1960s, they were in a calorie deficit, meaning that they were eating fewer calories than they required, which may be contributing to their longevity,” she says. “Okinawans tend to follow the 80% rule, which they call hara hachi bu. This means that they stop eating when they feel 80% full, rather than 100% full. This prevents them from eating too many calories, which can lead to weight gain and chronic disease.”

In addition, people in some Blue Zones drink one to two glasses of red wine per day, which may help prevent heart disease and reduce the risk of death. And while people in these zones don’t exercise in a gym, “activity is built into their daily lives through gardening, walking, cooking and other daily chores,” DeRobertis says.

[See: U.S. News’ 35 Best Diets Overall.]

Does the Blue Zone Diet Work?

A study of the claimed centenarians found there may be some “fraud and error” in the statistics used to designate Blue Zones, DeRobertis says. “However, there is enough other substantiation for the health benefits of the diet and lifestyle modifications, even if the actual number of centenarians was not entirely accurate. These are still healthy lifestyle choices to aim to adapt that have been well documented,” she says. “I think that people should review the findings of the Blue Zones and see what makes sense to incorporate into their lifestyle. People who make these changes usually lose weight, feel more connected to their community and feel less stress. There is no harm in adapting any of these principles. So yes, overall this is a lifestyle that I would recommend.”

Not everyone agrees, of course. “I recommend some, but not all of the recommendations,” says Aileen Birkitt, a registered dietitian and owner of Nutrition 4 You in North Kingstown, Rhode Island. She agrees with getting proper sleep and exercise, a greater focus on whole grain and plant-based foods and stopping eating when you are “almost full.”

However, Birkitt disagrees with “the highly restrictive focus. It is very hard to avoid all sugar and processed foods in our society. Many times, the restriction and avoidance can lead to bingeing in those who are prone,” she says. Birkitt also disagrees with avoiding dairy. “Dairy products are important as they provide calcium and protein to the diet. Someone who is not having these products needs to be sure to get enough calcium from other sources.”

Birkitt also warns against the Blue Zone diet for anyone who has an eating disorder or a history of an eating disorder. “The avoidance of so many foods may cause someone to restrict foods that they might be able to eat in moderation, which might cause them to overeat from all the restricting and then feel guilt afterwards,” she says.

Bottom line: As with all eating plans, it’s best to consult with a dietitian or nutritionist before making any changes to your diet. A specialist can help you pick the plan that will work best for your health history, lifestyle and, most importantly, what you like — and don’t like — to eat. After all, no eating plan works if you don’t enjoy it and stick with it.