Unlocking The Secrets To A Long And Healthy Life: Habits That Matter

Most of us want to live long and healthy lives, free from the burden of illness and disease. Thanks to advances in science and medicine, human life expectancy has been increasing, particularly in developed countries, over the past 200 years.¹ However, scientists have observed that there are areas of the world where people are living much longer than others, even once scientific and medical progress is accounted for.²

What can we learn from these places - dubbed “blue zones” - that could help us to stay healthier for longer?

By examining information from blue zones, scientists have identified nine key areas that may hold the secrets to a long and healthy life.² Here, we will explore each of these areas, in turn, to consider what habits matter in our pursuit of longevity!

Life expectancy - trends in recent centuries

Global average life expectancy is now over 70 years - more than double what it was in 1900, although significant inequality between developed and developing countries remains.¹ In the UK, life expectancy has increased from between 30 and 40 years in the 19th century to over 80 years today - trends which are not dissimilar in other developed countries like the US and Japan.¹ In contrast, in parts of Africa, life expectancy at birth is currently between 50 and 60 years of age.¹

The reasons for advances in life expectancy are multifactorial. Initially, improvements in living standards and sanitation played a large role, helping to reduce the spread of infectious diseases. As a result, more people were living into adulthood. The advent of antibiotics represented another win for longevity, as did the development of vaccinations, which meant that many historically significant infectious diseases no longer represented the threat that they once did. Later on, lives were extended due to advances in disease prevention and management, particularly concerning heart disease and cancer.³

It is clear that great progress has been made in terms of human life expectancy over just a couple of centuries. What, though, can we learn from the world’s centenarians about how to extend our lives even further?

Blue zones

Today, the highest life expectancy is found in Japan, at nearly 85 years.⁴ However, even once improvements in public health, living standards, and medical care are accounted for, there are areas around the world that have been observed to have a disproportionate number of residents living over 100 years of age. These areas have been dubbed “blue zones”, five of which have been identified to date:²

• Loma Linda, California, USA
• Nicoya, Costa Rica
• Sardinia, Italy
• Ikaria, Greece
• Okinawa, Japan

Around 20% of our longevity is thought to be linked to our genes.⁵ But what about the remaining 80% dictated by our lifestyle and environment? By examining how people in blue zones live, scientists believe they may have identified nine key areas that could contribute to the particularly good health and long lives of people in these areas.²

By examining each of these areas in turn, could we uncover some of the secrets to living a long and healthy life?

Area 1: Physical activity

People living in blue zones were found to have high levels of low-intensity physical activity. Rather than spending hours in the gym, they were mostly doing this within their usual daily routine - by walking, engaging in manual tasks, tending to their gardens, and so on.²

Perhaps this finding is not surprising, given that it is in keeping with existing evidence linking regular physical activity with longevity. A 2022 study examined the exercise habits of over 115,000 Americans over 30 years and found that those who did more than the recommended amount of weekly physical activity had lower death rates. The risk of early death was reduced the most in those who did 150–300 minutes per week of vigorous activity, 300–600 minutes of moderate activity, or any equivalent combination.⁶ You can read about what types of exercise count as moderate or vigorous here.

Area 2: A sense of purpose

What’s your reason for getting up in the morning? If you can clearly state your life’s purpose (your “ikigai” in Japan or your “plan de vida” in Costa Rica), then good news! Several studies have shown that having a strong sense of purpose in life is linked to a reduced risk of dying from any cause.^{7, 8}

Your purpose can come from anywhere, such as your career, voluntary work, your hobbies, or your role in family life. If you’re lacking purpose, consider starting small, perhaps by offering a few hours of your time each week to a cause that’s close to your heart. 

Area 3: Managing stress

Statistics from the Mental Health Foundation show that in 2018, 74% of the UK population reported high levels of stress in the preceding year, with 32% reporting experiencing suicidal thoughts as a result. Chronic stress has been shown to have a number of negative health consequences - from structural changes in the brain to alterations in the immune system and cardiovascular function.⁹

Although people living in blue zones are not immune to stress, it was observed that they did exhibit healthy coping mechanisms. For example, those in Okinawa spend a little time each day to remember their ancestors, whilst people in Loma Linda pray.² Taking a little time each day to be mindful, as those in the blue zones are doing in their own ways, has been proven to counteract some of the psychological and biochemical changes that can result from chronic stress.^{9, 10}

Click here for some suggestions from Mind on how to incorporate mindfulness into your daily life.

Area 4: Eating to maintain a healthy weight

Have you ever noticed how easy it is to mindlessly overeat when having dinner in front of the TV? In the blue zones, the absence of overeating was a consistent finding.² In Okinawa, residents have a motto – “Hara hachi bu” –  that reminds them to finish eating before they are full. Those in the blue zones also tend to have their smallest meal latest in the day, with those in Sicily having an overnight fasting window of around 18 hours between dinner and breakfast.^{2, 13} Taken together, could these factors be helping residents to maintain a healthy weight?

A study of 3.6 million UK adults showed that being underweight (BMI <18.5), overweight (BMI 25-29) or obese (BMI 30+) was associated with a reduced lifespan when compared with those who had a healthy weight. Being underweight shortened life by 4 years, whilst the most severely obese people (with a BMI of over 40) lived an average of 9.1 fewer years on average.¹¹

The scientific evidence as to the benefits of various approaches to mindful eating on weight management is mixed. Therefore, it is not possible to state whether incorporating mindful eating into your day will yield the same benefits for weight that those in the blue zones appear to enjoy.¹² Further research is also required to establish the role of meal timings on weight management and longevity.¹³

What we do know is that maintaining a healthy weight is crucial.¹¹ Click here for some tips on maintaining a healthy BMI. 

Area 5: A (mostly) plant-based diet

Regardless of where in the world they live, those in the blue zones eat a diet with very little, if any, meat. They also eat plenty of complex carbohydrates and legumes (like tofu, beans, lentils, and chickpeas).² These choices have previously been linked to a longer life in scientific research.^{14, 15}

Area 6: Wine in moderation?

Most people living in blue zones were found to drink moderately - around 1–2 glasses of wine per day.² Whilst some studies have linked moderate consumption of wine with a lower risk of heart disease, a large 2018 study showed that alcohol use was associated with negative health outcomes, regardless of quantity.^{16, 17}

If you do choose to drink alcohol, UK guidance suggests that drinking fewer than 14 units per week can reduce the impact on your health - that’s around 6 medium (175ml) glasses of wine or 6 pints of 4% beer.¹⁸

Area 7: Faith

Faith was found to play an important role in the lives of most people living in blue zones. So, if this is also true for you, then good news - several studies have suggested that regular participation in religious services adds years to your life!^{19, 20}

Areas 8 and 9: Connections with family and friends

Centenarians in the blue zones were usually found to maintain close family ties. Spousal relationships were highly valued, grandparents supported in the raising of children, and children tended to live near their ageing parents later in life.² Perhaps these findings were not surprising, given that multiple studies have confirmed the positive impact of strong family connections (including marriage) on longevity.^{21, 22}

Those in the blue zones also value lifelong friendships.² Perhaps the benefits here could be twofold - through both increased socialisation in older life (which has been linked to longevity) and by reinforcing shared positive health choices.²³ Research shows that people with social connections to those with obesity were more likely to become obese themselves, suggesting that those we surround ourselves with influence our own health behaviours.²⁴

Summary

Human life expectancy has increased dramatically over the past 200 years due to improvements in healthcare and living standards. Global life expectancy is now over 70 – although there is significant variation between individual countries. 

Scientists have identified five distinct areas around the world where people live to very advanced ages – often over 100 years – at a rate much above what one would expect in the general population. These areas have been named “blue zones”.

By studying the lifestyles of people living in blue zones, several factors have been identified as possible contributors to the longevity of the residents of these regions. Some themes, like regular physical activity and social connectedness, are well supported by existing scientific literature. For others, like the suggestion that moderate wine intake could extend life, the burden of evidence suggests that this is likely not the case. 

Helen Maginnis

MBChB, BSc. (MedSci) Genetics, University of Glasgow

Helen is a former NHS doctor living in Scotland. She discovered her love for medical writing while working in the charity sector with families affected by Huntington’s disease. She has a special interest in rare genetic disorders and has conducted laboratory research examining the impact of collagen IV gene mutations in mice. Helen values diversity in all its forms and is a passionate LGBTQ+ rights advocate.

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