Into The Blue Zone: Sardinian Lessons for Longevity

Sardinia, a small Mediterranean island off the coast of Italy, is home to a cluster of mountainous villages with some of the highest life expectancies in the world. This group of villages constitutes the first ever “Blue Zone Region” to be identified. “Blue Zones” are defined as places in the world where residents often reach the age of 90 or older. Sardinia is now one of five “Blue Zones” in the world, with the other four being Icaria (Greece), Okinawa (Japan), Nicoya (Costa Rica), and the Seventh-day Adventist community in Loma Linda, California. Sardinia is well-known for its large number of centenarians (a person who is 100 or more years old). In May 2010 alone, there were 350 centenarians in Sardinia at an average rate of about 22 centenarians per 100,000 inhabitants. This is nearly ten times more centenarians per capita than in the US and more than double the global average of about 8 to 10 centenarians per 100,000. There are many competing theories on the extraordinary longevity of the Sardinian people. Rather than focusing on a singular contributing cause, it’s clear that a multitude of factors lead to a longer and healthier life in the region. It’s important to acknowledge that life expectancy is not solely determined by diet, exercise, and genetics. Factors such as social environment and community culture also play a significant role. 

Genetic Advantage

Pino Ledda, the lead researcher of the Blue Zone Project in Sardinia, argues that genetics are important in explaining the longer-life spans in Sardinia. She claims that “[g]enetics is the main thing. The individuals living to these ages are almost always related.” Men tend to live just as long as women in Sardinia which is scarcely seen elsewhere on earth. Among the 20 centenarians living in the Sardinian village of Seulo over the past two decades, 11 were men. Conversely, in the United States, there are five female centenarians for every one male centenarian. This curious anomaly was the catalyst for scientific studies into Sardinian genetics and longevity. Researchers discovered that in the remote and isolated mountain villages of Sardinia, the gene pool is rather small. There’s also a tendency to marry within the same social group, rendering the Sardinian population very homogenous. Over time, this may generate special features within the population from a genetic perspective. 

Lifestyle Choices

The food and diet of Sardinian residents is a significant contributing factor to their overall longevity. Sardinians will often harvest, fish, and hunt for the food that they eat. The classic Sardinian diet consists of garden vegetables, fruits, beans, whole-grain bread, and in some parts of the island, mastic oil. Meat is not eaten frequently and is typically reserved for Sundays or special occasions. Pecorino cheese, which is rich in omega-3 fatty acids that can improve cardiovascular health, and goat’s milk which helps protect against inflammatory diseases such as Alzheimer’s, is also consumed throughout Sardinia. It’s worth noting that in Sardinia, lunch is the biggest meal of the day. A typical Sardinian lunch may consist of a homemade pasta with pecorino cheese and a salad. On the other hand, dinner is the lightest meal of the day, often served late in the evening. A commonality between all the food in Sardinia is simplicity and freshness. The lack of processed foods certainly contributes to the overall health of people living in the region. There is also moderate wine consumption in Sardinia, and the local wine (Cannonau) is rich with antioxidants and polyphenols which offer numerous health benefits. Cannonau wine also has up to two or three times the amount of artery-scrubbing flavonoids as other wines. Some researchers believe that moderate consumption of Cannonau wine may explain why there are lower levels of stress among men in Sardinia. Zelinda Paglieno, a local Sardinian who was interviewed in 2017 at the age of 102, claimed that “two fingers width” of red wine at lunchtime everyday is one of the keys to living a long and healthy life. 

Another important aspect of the Sardinians’ healthy lifestyle is exercise. The terrain of many Sardinian villages is steep and mountainous, providing ample means for physical exertion. For the most part in Sardinia, people aren’t driving, they’re walking. As a result of the steep landscape, locals are getting low to medium intensity exercise almost all the time. Many Sardinian shepherds may walk five or more miles a day, which, as one might expect, provides substantial cardiovascular benefits.

The Family Factor

Outside of the more obvious factors that may impact life expectancy—including the aforementioned genetics, diet, and exercise—social factors such as community, culture, and family also play an important role. Demographer and physician Dr. Giovanni Pes posits just this as she claims that “research in this Mediterranean region indicates that social interaction may be just as influential” as other factors when it comes to living a long life. In Sardinia, there are strong family values which assure that every member of the family is taken care of. In addition, there is an emphasis on celebrating elders. While in the US, elderly people may live in retirement homes, separate from their family, Sardinians keep their elders close and cherish them to the fullest extent. Elderly people are often put to work by gardening, cooking, and watching after the kids. The University of Cagliari’s psychology department found that according to a 2017 study, older people in Sardinia engage in more social and leisure activities than older populations in other parts of the world. There is also a very relaxed work culture in Sardinia that may be imperative to men when it comes to longevity. The low-stress work environment makes it so that most people’s number one priorities are their families, not their careers. 

The emphasis on family in Sardinian culture may be the key to their healthy lifestyles. There are sometimes two to three generations of a family all living in the same household which illustrates how tight family connections are in this region. Grandparents will often perpetuate traditions and push children to succeed which may ultimately lead to healthier and more well-adjusted lives for their grandkids. This strong sense of tradition in Sardinia is reflected in the many festivals and events that take place throughout the year. There’s really no option for loneliness in Sardinia considering that the community and family culture is so strong. Moreover, it’s no surprise that people in closely connected, healthy families suffer lower rates of depression, suicide, and stress. While Sardinia is an island with low income and endemic disease, making for a less-than ideal health situation, it is their tight-knit relationships (according to Dr. Pes) that help residents cope with difficulties in their later years.

In Closing

There’s many things to consider when evaluating the lifestyle choices and external factors that lead to longer life expectancies in the Sardinian Blue Zone. Whether it's the small gene pool, the simple diet and antioxidant-rich wine, the daily walking and exercise, or the family-first culture, Sardinians have cracked the code to living a long and healthy life. Sardinia from a scientific perspective seems to highlight the importance of social factors in affecting longevity which is often overlooked by governments and institutions. However, as is true with other Blue Zones around the world, there’s no singular root cause; rather, it’s necessary to consider a myriad of factors that ultimately contribute to Sardinian longevity.