Date: 09-02-2023

Professor Avni Sali AM


The New Year brings renewed possibility for a fresh start and inspires a range of resolutions.  No matter what your age, adopting a healthier lifestyle can improve your health and life, it’s never too late!

As a guide to inspire us to live the best life we can, we can adapt some of the principles from the long-term studies such as The Blue Zones: lessons for living longer from the people who’ve lived longest, Dan BuettnerThey studied a series of populations in five diverse zones across the globe, who were known for their health and longevity and concluded there were particular lifestyle patterns consistent in these populations that contributed to healthy ageing and longevity. We may be a long way from the lifestyles in Okinawa, Sardinia, Ikaria, Linda Loma and Costa Rica, but we can adopt some essential basic principles into our own daily living.

Dr Dean Ornish, a USA leading medical professor, also spent more than 35 years studying the effects of lifestyle on disease, and established effective treatment and prevention programs based on behavioural, dietary and exercise changes with proven results for heart disease, ageing and cancer. His protocols mirror the findings of the Framingham Study into the effects of lifestyle on risk factors for cardiovascular disease and other chronic illness, which is notable for its tri-generational investigations. Founded in Boston, in post-war America in 1948, the Framingham Study focused on lifestyle and health and to this day offers us powerful results and insights into not only treating illness, but more importantly, preventing ill health though healthy lifestyle habits. 

The key is to start now, start with small steps with the goal of lasting change, and to adapt our thoughts and beliefs to a way of life that allows us to enjoy the benefits of ‘holiday mode’ every day of the year.  To achieve lasting change, professional support is encouraged.

So, what are the key elements of health and longevity according to these researchers?

If we consider the key messages of these studies, we see a model emerge that today offers us a framework for longevity, wellbeing and optimal health that has long been advocated by Integrative Medicine.

Buettner stresses that the beauty of the Blue Zones is not one or two big things, but a “constellation of little things that add up.”  

Diet is just one part of the picture, while social activity, community support and a strong sense of one’s purpose are other integral factors.  It is becoming clear that cultural factors to do with human behaviour, in particular human contact and reducing isolation are most vital for our health. 

With these culturally diverse locations, obviously Okinawa varies greatly from Sardinia.  A common denominator was a predominately plant-based diet but not exclusive, for example fish is eaten in Sardinia and Ikaria.  Focus with the five pillars to every Blue Zone diet being – whole grains, greens, tuberous vegetables, nuts and beans.  Diets are typically low in animal products, but included some fish consumption and some cheeses, such as the Sardinian sheep-milk, pecorino cheese which is high in omega-3 fatty acids.

In Okinawa for example, green tea is regularly taken, whilst in Ikaria it’s usually a tea made with oregano, rosemary or mint.  Red wine with food is also consumed in some zones.

So how do we in our busy societies adopt some of the Blue Zone’s practices?


Dietary factors are the ones that we can most easily modify. We can embrace the best aspects of all these diets, as in Australia we have access to a wide variety of fresh healthy food options.

Many studies support the benefits of a traditional Mediterranean diet on health and prevention of chronic illness in general.   The Mediterranean diet generally, is noted for its fresh fruit and vegetables; moderate consumption of alcohol, particularly red wine, which is rich in polyphenols and served with food; quality protein an fibre sources such as legumes; less red meat; fresh non-farmed fish; nuts and seeds, whole grains, and especially large quantities of extra virgin olive oil.  Dairy and meat consumption is not eliminated but modified – less is consumed but of a higher quality – a goats milk fetta, for example, rather than a processed cheddar.   The Mediterranean diet is typically very low in processed foods.  It should be noted that the Mediterranean diet does vary greatly amongst different countries in this region. 

The similarity of cultural factors in Mediterranean countries, are more likely to be important for health than their diets.  Whilst some components of this diet contain unhealthy foods such as sweets and preserved meats, what is likely to be more protective is the family structure that provides the context for eating and drinking in these cultures.

In particular the ‘getting-together’ and support of family and friends.

Be with people you love

A sense of belonging and feeling part of a community is health promoting!  The village life of Blue Zone populations created many opportunities for social engagements.  Spending time with others in a community setting, and with family and friends, helps establish strong networks and social support that is essential for prosperity and preventing isolation.  We know now from the growing research on ‘loneliness’ that it is extremely detrimental to health, and in some studies has been quoted as worse than smoking.  In 2018 the UK appointed the world first Minister for Loneliness, recognising the enormity of this problem.

Move throughout the day

Our increasingly sedentary lifestyles are now understood to be a major cause of ill health. In Blue Zone populations, continued activity is part of daily life.  Whilst they may not exercise in a structured way: walking sometimes steep terrains, working in gardens, or dancing and martial arts as the Okinawans. Any activity outside also has the added bonus of the sunshine vitamin, Vitamin D and also serotonin. Vitamin D is essential to every system in the body and deficiencies in individuals are currently at epidemic proportions.  Fresh air, sunshine and activity are not a ‘reward’; they are absolutely vital to health.  Humans are similar to outdoor plants; we cannot live without sunlight exposure.

Lessen the pace and get adequate sleep

Sleep disorders contribute to most diseases.  Abnormal sleep patterns predict lower life expectancy and insomnia contributes to mood disorders, obesity and reduced quality of life. Blue Zones participants not only reported good sleep, but regularly took a daily nap.  The more ‘outside’ lifestyle and sunlight exposure also contributed to better sleep quality.  Enjoy the state of being relaxed.  Meditation and other relaxation activities can provide a recharge for the system, in particular giving the brain a rest, especially in our fast-paced world.

Stress Less

Stress and depression increase stress hormone levels.  For example, cortisol and growth hormones increase insulin resistance, leading to elevated insulin levels.  This increases the chances of diabetes, cardio-vascular disease, obesity, cancer and other illnesses.  Stress is the most commonly given reason for not only poor health but also poor habits.   ‘Unloading’, talking about our problems with a confidante; group therapy; art; writing etc. is extremely beneficial.  To live longer and healthier we need to find ways to manage our stress, and the good news is, the healthier we are – the more we adopt this blueprint for optimal health – the less stress we seem to suffer.

A Meaningful Life

Participants in the Blue Zone study evidenced a sense of peace and harmony that may be derived from spirituality and cultivating a sense of meaning.  A sense of purpose and a reason for being was seen to be foundational to a happy life.   ‘Meaning in Life’ is different for all people, for some it may be linked to faith, others to nature, philosophy, art, the wondrous universe etc.

The Blue Zones centenarians all tended to belong to faith-based communities.  A strong community of Seventh-day Adventists were studied in Loma Linda, California who apart from promotion of healthy lifestyle, have a deep commitment to their faith.

Taking time daily to pray, meditate or reflect can bring a sense of calm and meaning.

We may feel that our world is a long way from Ikaria, or Okinawa, there is still much we can learn and adapt into our own Western-style busy lives.

We may not be able to change the world we live in, but we can change the way we live in the world. 

A happy and healthy 2023!



Ornish Lifestyle Medicine

Framingham Heart Study

Buettner, D (2008), The Blue Zones: lessons for living longer from the people who’ve lived longest, National Geographic Society

Kotsirilos V, VItetta L, Sali A, (2011)  A guide to evidence-based integrative and complementary medicine, Elsevier