What the Longest-Lived People in the World are Doing Different than Most Americans

Excerpt adapted from The Blue Zones Secrets for Living Longer: Lessons From the Healthiest Places on Earth by Dan Buettner, a beautifully illustrated and informative guide to the places on Earth where people live the longest—including lessons learned, top longevity foods, and the behaviors to help you live to 100—plus a surprising new blue zones longevity hotspot.

Most of what we think will help us live longer and healthier is misguided or just plain wrong. It’s common sense to get on a diet regimen, join a gym, and get our vitamins, right? Let’s take a closer look.

In 2021, Americans spent more than $151 billion on vitamins and supplements (vitamin C, omega-3s, multivitamins, and the like). But the biggest, most dependable studies show that people who take supplements actually live shorter lives than people who don’t. Americans spent another $21 billion or so on protein supplements. But according to the Centers for Disease Control and Prevention, the average American gets about twice as much protein as they need. In fact, no supplement, pill, hormone, or vitamin has ever proved to extend life expectancy in humans.

The concept of exercise—physical effort carried out to sustain or improve health and fitness—has been around in the United States since at least 1820. It’s a nice idea to stay fit. And indeed, people who stay physically active have about a 30 percent lower chance of dying in any given year than people who aren’t active. But despite the $160 billion per year Americans spend on trying to exercise, only about a fifth of all adults get the minimum recommended amount of vigorous activity (about 11 minutes a day). That means exercise is not working for more than 200 million Americans.

Similarly, diets are a well-intentioned but colossally ineffective approach to staying healthy and living longer. They fail for almost everyone almost all the time. Take 100 people who resolve to diet on New Year’s Eve and by January 19 most will have abandoned the effort. By August only 10 percent will still be trying to eat better, and within two years the success rate will be under 5 percent. If your financial planner returned those yields, you’d fire him. Yet we spend $200 billion a year thinking that this time the diet will work.

So, if the most common approaches to better health and longevity don’t work, what does?

In the early 2000s, I set out to reverse engineer longevity. Under the mentorship of Dr. Ancel Keys and Dr. Robert Kane of the University of Minnesota’s School of Public Health, I relied on two assumptions: First, genes have relatively little impact on how long we live. A Danish twin study in 1996 found that longevity is only mildly heritable, accounting for only about a fourth of the health differences among people. The rest is largely driven by our environment. Second, in those places around the world where people are living longer, they’re doing something right. If I could find demographically confirmed areas where people were living the longest and identify the lifestyle commonalities of those regions, I might discern some clues.

Rather than searching for answers in a test tube or a petri dish, I looked for them among populations that have achieved what we want—long, healthy lives and sharp brains until the end. The idea garnered a grant from the National Institutes on Aging and a National Geographic assignment.

Armed with a plan, I began a worldwide search for longevity pockets. I knew that in Okinawa, Japan, Drs. Makato Suzuki, Bradley Willcox, and Craig Willcox had already identified a population that produced the longest-lived people in the history of the world. As I quickly discovered, Dr. Gianni Pes, a medical statistician from the University of Sassari, was also tracking down centenarians on the island of Sardinia in Italy. In the island’s mountainous interior, which he referred to as the “blue zones,” he found a cluster of villages that produced about 10 times more centenarians per capita than the United States. (I liked the term “blue zones” and evolved it to denote any confirmed longevity hot spot around the world.) Later, Dr. Michel Poulain confirmed Pes’s research, and together they published their findings in the journal Experimental Gerontology.

In the United States, Dr. Gary Fraser of Loma Linda University was publishing findings from the Adventist Health Study, research that followed more than 30,000 Seventh-day Adventists in Loma Linda, California, for some 20 years. He found that adherents of the church were living about seven years longer than their Californian counterparts.

Later, with grants from the National Geographic Society, I led projects to discover longevity hot spots on the Greek island of Ikaria and on the Nicoya Peninsula of Costa Rica. In a 2005 cover story for National Geographic and in my 2008 book The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest, I profiled each blue zones region and distilled the common denominators: The residents of these hotspots were mostly eating a whole-food, plant-based diet, and instead of trotting off to the gym, they moved naturally every 20 minutes or so. Daily rituals like prayer, ancestor veneration, and napping also helped them downshift and lower stress-induced inflammation. And long before people were talking about the social determinants of health, I attributed Sardinians’ longevity to their propensity for keeping their aging parents nearby—extending life expectancy for both grandparents and grandchildren—and Okinawans’ to their social support groups (called moais) and their sense of purpose (ikigai).

The Blue Zones brand of longevity didn’t promise that it could help you outlive the biological limits of the human machine. Fact is, the current maximum life expectancy for people in the first world (i.e., those not beleaguered by infectious diseases such as malaria, dysentery, and cholera) is about 93 years—less for men and a little longer for women. But in the United States, life expectancy is only 77. We are leaving 16 years on the table. “Why?” I wondered.

The answer wasn’t that people in blue zones had better genes or superior bodies. Most of them didn’t. Rather, they avoided the chronic diseases that foreshorten our lives here in America, from diabetes to cardiovascular disease to dementia to certain types of cancers. They avoided these diseases not because they possessed more discipline or a greater sense of individual responsibility, but rather because they lived in environments that made it easier for them to do so. In other words, they didn’t pursue health and longevity as if it were a chore. Their health and longevity stemmed from their surroundings.

This insight changed everything. It meant that if we wanted to help improve the health and longevity of Americans, we needed to focus on the environments in which they lived—their communities, workplaces, and homes and the businesses they patronized—rather than trying to change their behaviors.

I started to think about applying what I’d learned in blue zones to make life better here in the United States—to “manufacture” a blue zones [hotspot] of our own. Decades ago, the National Institutes of Health funded a half dozen “heart healthy” projects in cities throughout the country, where communities tried to implement diets, exercise programs, and health education. In each case, the researchers saw small improvement in heart health indicators in the short run, but all the efforts failed to show improvement in the long run.

I decided to try a different approach. My goal wouldn’t be to change people’s behavior, but rather to shape their environments—to make healthy choices the easiest ones. In 2008, with a grant from AARP, I put together a team to give it a try. We chose Albert Lea, Minnesota, a community of 18,000 people. The mayor, city manager, school superintendent, local hospital, and business leaders all pledged their support for the project.

With some of the most talented experts in the country, we developed a policy bundle to improve the walkability and bikeability of Albert Lea and slowly transform the city’s street designs from car-friendly to people-friendly. We put together a school program that favored healthy foods over junk foods. We persuaded restaurants and grocery stores to make healthy foods easier to find and more enticing to eat. We introduced a Blue Zones Pledge for individuals that eventually enrolled 25 percent of the city’s adult population into volunteering and taking workshops on how to pursue their sense of purpose. Finally, we developed a process to help like-minded people get together in walking groups—not only to get them out moving but mostly to build new friendships. We knew that if we could organize friends around healthy behaviors, those behaviors were more likely to stick.

The first Blue Zones Project ran for about 18 months. “The results were remarkable,” Harvard’s Dr. Walter Willett told Newsweek magazine. As data gathered by Gallup showed, we raised the life expectancy of the average citizen by three years and shaved about 30 percent off the city’s year-over-year healthcare bill. The project worked not because we tried to change 18,000 people’s minds. We changed their surroundings.

Since then, we’ve brought the Blue Zones Project model to 72 cities across
the country, from Fort Worth, Texas, to Naples, Florida, as well as to the entire states of Iowa and Hawaii. We’re changing things for the better—one community at a time.

Nearly 20 years after I first landed in Sardinia with a backpack and a National Geographic assignment, I returned to all the blue zones to produce a four-part series for Netflix. Like everywhere else in the world, the blue zones have changed—mostly because of modernization and the devastating impact of American food culture. But a bevy of scientists continue to study them. Dr. Luis Rosero-Bixby has been tracking the health in the Nicoya Peninsula. Fraser continues to mine the decades-long Adventist Health Studies for new dietary guidelines. Suzuki and the Willcoxes continue to monitor Okinawa’s centenarians. Pes, who I believe is the world’s greatest longevity expert, is still at work in the mountain villages of Sardinia, where strong traditions and remote locations continue to preserve the factors that make them extraordinary. And in Ikaria, Romain Legrand, a researcher from Dijon University Hospital, published a survey of people over age 85 that confirms the importance of socializing, taking naps, swimming, gardening, and more.

Despite traveling with a production crew of some 20 people for the Netflix series, I occasionally had time during my journeys to reflect on my many experiences in the blue zones. I recalled nostalgically the 30-some trips I’ve taken over the years, the experts who’ve helped me along the way, and the many centenarians I’ve met—almost all of whom are gone now. I wrote almost 100 pages of notes during the four months of filming and in the process realized that I had gleaned more insights about the blue zones. Those notes have inspired The Blue Zones Secrets for Living Longer.

Late one night [during Netflix filming], jet-lagged and wired-tired, I wrote the
following in my journal: Though we in the United States live in the most prosperous
country in the history of the world, we’re more overweight, divided, and unhealthy than ever. Life expectancy has dropped every year for the past four years, as has overall happiness. So, if more prosperity doesn’t seem to be working for us, what else could?

My thoughts returned to the blue zones, where I’d learned the priceless value of slowing down, of engaging in long conversations with a neighbor, of unrushed family dinners, of eating low off the food chain, and of cooking at home. I recalled the counterintuitive joy of getting out from behind my steering wheel and back onto my feet. Of walking to the places I need to go—and if they were too far away, of moving closer to them. Of gardening instead of weight training. Of getting closer to family, to beauty, to nature, and to the rhythms of life that have set the tempo for the human species for the past 25,000 generations.

Excerpt adapted from The Blue Zones Secrets for Living Longer: Lessons From the Healthiest Places on Earth by Dan Buettner, a beautifully illustrated and informative guide to the places on Earth where people live the longest—including lessons learned, top longevity foods, and the behaviors to help you live to 100—plus a surprising new blue zones longevity hotspot.