UPDATED: June 28, 2025
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Netflix has a hit show called “Live to 100: Secrets of the Blue Zones.” It presents an inspiring story of happy and healthy elders who work hard in the morning, walk and dance a lot, and make their own food from scratch. Unfortunately, the film appears to be more of an infomercial for the diet books and “longevity” foods, beverages, and supplements that are sold on the Blue Zones website.
In reality, a new analysis found that a current life expectancy of 100 years is unlikely. No more than 15 percent of women and five percent of men might live that long. Overall lifespans in the U.S. appear to be declining. Unless the biological processes involved in aging can be markedly slowed by a wonder drug or other miraculous discovery, human life extension is improbable.
As yet, there are no clinically validated, effective anti-aging interventions for humans besides medical best practices, such as prescribing statins for high cholesterol, antihypertensives such as ACE inhibitors or ARBs for high blood pressure, GLP-1 RAs for obesity, and metformin for pre-diabetes. What we can hope to accomplish through lifestyle changes is to increase the number of years spent in relatively good health, often referred to by the nebulous term, “health-span.” Dr. Bestermann makes it clear that a healthy lifestyle alone is often not enough to slow aging and extend life:
The Blue Zones
Blue Zones are locations around the world where populations are alleged to have significantly greater longevity. However, this is more of a myth than a scientific reality, and some of the so-called “secrets” aren’t really secrets, but rather well-known, evidence-based components of a healthy lifestyle. Some of the other touted “secrets” have no evidentiary basis at all.
Many of the conclusions drawn about longevity are based on cherry-picked anecdotes and motivated reasoning, rather than scientific studies. As you surely know by now, oxymoronic “anecdotal evidence” does not pass scientific muster as being reliable data. When scientific methods are applied to observational studies, the known confounding variables are identified and statistically accounted for, the study’s limitations are acknowledged, and the authors’ conflicts of interest are fully disclosed. As far as I know, the “Blue Zone Diet” has never been subjected to any scientifically rigorous research.
According to an independent analysis of the Blue Zone data set regarding longevity, the remarkable age records exhibit patterns indicative of clerical errors and pension fraud. One of the alleged Blue Zones is Okinawa, Japan. Data from Japan’s Ministry of Health shows the average life expectancy for Okinawa’s men is 81 years, and for women 87 years, which is not all that impressive when compared to the rest of Japan’s population. Only a third of Okinawa’s centenarians were functionally independent, while two-thirds needed major assistance or were very disabled. So, even in Okinawa, the most fortunate thing about getting really old is that it doesn’t last too long.
What the “Blue Zone Diet” does have going for it is a passing similarity to the Mediterranean Diet, with its emphasis on whole, natural, plant-based foods. The MEDLIFE study (and DASH and MIND diets) do have strong scientific evidence that eating lots of fruits, vegetables, and whole grains, reducing one’s intake of salt and sugar, and lifestyle habits that include sufficient rest, physical activity, and positive social interactions, can result in a lower risk of all-cause mortality. A new study found the strongest evidence yet that a Mediterranean diet is associated with a lower risk of cognitive decline in older adults.
According to an American Council on Science and Health report, the “Blue Zone Diet” is replete with fictional superfoods, contains generous servings of half-truths, and is well-seasoned with blatant misinformation about longevity. When it comes to describing a healthy lifestyle, it has nothing new to offer. As far as I’m concerned, the overall quality of my life is far more important than its quantity. Consequently, one’s “health-span,” the number of years of relatively good health, has greater value than a long lifespan with too many years of illness and infirmity as it nears its end.
Blue Zone Vitamins
Blue Zone vitamins are nothing special, and they lack USP verification. Let’s face it: People are being scammed by predatory “wellness influencers” and snake oil salespersons. For more information about the good, the bad, and the ugly in the supplement industry, see:
It might be true that people who take a vitamin supplements live longer, but concluding that vitamins produce a longer lifespan would be incorrect. There are myriad other things about people who are inclined to take multivitamins that could result in a healthier and longer life. For example, people who have more disposable income can afford not only multivitamins, but many other things that contribute to better health, including better access to good medical care.
In a landmark study, pre-tax household earnings from 1.4 billion deidentified U.S. tax records were compared to race- and ethnicity-adjusted life expectancy at 40 years of age. The study found that higher income was associated with greater longevity, and differences in life expectancy across income groups increased over time. Now, if doctors could prescribe wealth….
Methodological Flaws and Corrupt Data
The Blue Zone studies are so corrupted by methodological flaws, wishful thinking about longevity, and self-serving motives for increasing fame and fortune, that there is no way to know what’s valid data and what’s not. For a deeper dive into the Blue, see:
For a detailed critique of the Blue Zone’s data flaws, see:
Ignore the slick marketing of pie-in-the-sky, Blue Zone trademarked, longevity products, and instead focus on increasing your healthspan:
What’s good for your brain is also good for your body:
An Unholy Alliance?
The American College of Lifestyle Medicine (ACLM) and Blue Zones have recently formed a strategic partnership. We are already aware of the profit motives behind the Blue Zones. The financial implications and potential conflicts of interest resulting from this partnership could undermine the credibility of the ACLM.
Don’t confuse the ACLM with the American College of Preventive Medicine (ACPM), which was established more than 70 years ago. The ACPM focuses on improving the health and quality of life of individuals, families, communities, and populations, through disease prevention, health promotion, and heath policy initiatives. It does not provide abundant opportunities for commercial exploitation of the healthcare system by unscrupulous providers.
The biggest problem with so-called lifestyle medicine is that its certified practitioners, like devout vegans, develop an almost religious fervor about it. They think of lifestyle modification as a panacea, and like most religions, they are able to use their belief system to separate the faithful from their money.
All the while, good information about how to have a healthier lifestyle is readily available for little or no cost, such as through my free newsletter. Lifestyle counseling doesn’t require ordained clergy. All it takes is a knowledgable and ethical healthcare practitioner, or a health professional who provides clear and accurate information.
I do consider a healthy lifestyle an important factor in reducing the risk of developing chronic illnesses and increasing longevity. Healthy living is certainly good preventive medicine. However, when it comes to the treatment of illnesses that have already developed, lifestyle interventions can be used as an ancillary modality, but not as the only thing. One need look no further than the treatment of obesity to recognize that the current medications are far more effective than diet and exercise alone.
If the ACLM-Blue Zones partnership involves financial incentives related to promoting specific products or services, there's now a chance that the ACLM’s recommendations could be influenced by profit motives, rather than being based solely upon scientific evidence and furthering patient health. This could sabotage the good work that is being done by the ACLM. The organization should not be in the business of promoting dietary supplements of dubious value.
While some of the Blue Zones research does have value, there's clearly a risk that overemphasizing this specific approach to lifestyle medicine will be at the expense of other evidence-based strategies. The partnership could also create unfair competition with organizations or healthcare providers who offer other kinds of lifestyle interventions or have different approaches to promoting health and well-being.
Any failure of either organization to maintain complete transparency and fully disclose any potential conflicts of interest will undermine public trust. This transparency must include all financial relationships, funding sources, and any potential biases. Both organizations will need to have clear guidelines and policies in place to address potential conflicts of interest, including disclosure requirements and processes for managing those conflicts.
There are bound to be unintended consequences resulting from the uncritical endorsements and lax applications of lifestyle medicine, including the infiltration of pseudoscience, profiteering, and the potential for widening health inequalities. Lifestyle medicine, by its very nature, is especially susceptible to misuse.
Unfortunately, a public relations campaign called the True Health Initiative has been created to disparage any criticisms of the Blue Zones and gaslight those who have legitimate concerns about its credibility. The past president of the ACLM, who now serves as science advisor to Blue Zones, is also the founder of the True Health Initiative. If you want to know what is really going on here, it will be necessary to follow the money!
For a lot more information on the Blue Zones hype, see:
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