Human health

The Blue Zone argument for plant-based diets is flawed

The concept of Blue Zones is often used as a blueprint for longevity, promising insights into the secrets of a long and healthy life. Since its popularization in 2005, the Blue Zone narrative has emphasized ‘plant-based’ diets as the cornerstone of health and longevity. However, beneath the polished image lies a more complex reality. Below, the myths surrounding Blue Zones will be addressed, challenging its oversimplified dietary stereotypes and exposing its flaws.

Blue Zones: why is the concept problematic?
The misrepresented case of the Okinawan diet
Animal-sourced foods in Blue Zone diets

List of key resources

Blue zones: why is the concept problematic?

The term ‘Blue Zones’ refers to regions renowned for exceptional longevity, including Ikaria (Greece), Okinawa (Japan), Sardinia (Italy), Loma Linda (USA), and the Nicoya Peninsula (Costa Rica). Coined in 2005, the concept attempts to connect ‘plant-based’ diets with extended lifespans. It has been adopted by the Seventh-Day Adventist Church in 2020 to advocate for dietary restrictions on animal-based foods. However, the concept is severely flawed and has faced criticism for a number of reasons.

Contrary to popular belief, Blue Zone populations are mostly omnivorous and consume substantial amounts of animal-sourced foods, undermining the narrative of ‘plant-based’ eating. Full-fat dairy and fish are cornerstone foods in some of these regions, whereas pork holds a particular place in traditional Okinawan and Sardinian cuisine.
The identification of supercentenarians in some of these remote communities relies on unreliable data, including age-reporting errors, skewed interpretations, clerical mistakes, missing birth records, and even instances of pension fraud.
Longevity in Blue Zones is shaped by a range of non-dietary factors, such as active lifestyles, strong community bonds, and low stress levels, complicating efforts to isolate the role of diet.
The focus on lower mortality rates distracts from other health outcomes that are not necessarily superior. For instance, the Adventist community in Loma Linda face reduced sperm quality and higher risks of stroke and dementia among older vegetarians.
Globally, across regions, higher meat consumption is correlated with increased life expectancy, challenging the assertion that its avoidance is inherently linked to longer, healthier lives.

CLICK HERE for evidence

Blue Zones® - what are they?

A link between 'plant-based' eating in local and traditional communities with exceptional longevity (so-called 'Blue Zones') is often advanced in support of animal source food restriction or vegetarianism [Poulain et al. 2004]. Such communities have been identified in Ikaria (Greece), Okinawa (Japan), the Ogliastra Region (Sardinia), Loma Linda (USA), and the Nicoya Peninsula (Costa Rica). The concept goes back to 2005 [Buettner 2005] and has since been acquired by the Seventh-Day Adventist Church as Blue Zones® [BlueZones], in support of their dietary evangelism for meat restriction [see elsewhere].

Why is the concept problematic?

The Blue Zones argument may be flawed for various reasons. Firstly, identification of supercentenarians in Blue Zones may suffer from age-reporting errors, skewed interpretations, and registration errors and fraud in remote communities (clerical errors, absence of birth certificates, pension frauds) [Newman 2024]. Secondly, the longevity data are strongly confounded by factors beyond the diet, since members of Blue Zones lead healthy lifestyles in general and are part of functional social communities. A similar case for longevity has been made for the Mormon community [Enstrom & Breslow 2008]. Thirdly, and in contrast to what is being said, the intake of animal source foods in the Blue Zones can be substantial (see below).

Health is not necessarily optimal in the Blue Zones

The argument for meat avoidance falls apart when comparing longevity across different communities worldwide. When looking globally into 175 contemporary societies, meat intake is generally associated with a higher, not lower life expectancy [You et al. 2021]. The global PURE cohort has demonstrated that the intake of unprocessed red meat leads to neutral to protective effects on mortality across regions [Iqbal et al. 2021; Mente et al. 2023], whereas full-fat dairy and fish were identified as protective foods associated with lower mortality [Mente et al. 2023].

Blue Zones may have their own set of health concerns potentially caused by the prevailing diet, such as decreased sperm quality in the Seventh-Day Adventist community of Loma Linda [Orzylowska et al. 2016]. Moreover, a higher prevalence for stroke and dementia is found among older vegetarians within the Adventist community compared to non-vegetarians, despite lower incidences for all-cause and certain cause-specific mortalities for males and in younger subjects [Abris et al. 2024].

The misrepresented case of the Okinawan diet

The so-called Okinawan longevity diet, referred to as containing only 9% protein, does not accurately represent the traditional dietary habits of the region. Instead, it reflects a post-war snapshot from 1949, a time of scarcity when livestock populations had been reduced. While pre-war Okinawa had more than 100,000 pigs, only 2,000 had remained after the Battle of Okinawa. This period of hardship has been mistakenly generalized as the standard Okinawan diet, creating a Blue Zone stereotype.

Well on the contrary, research shows that Okinawan centenarians consumed twice as much meat as their counterparts on mainland Japan. Far from minimizing meat intake, Okinawans have long been known for their notable consumption of pork and goat meat and the traditional use of animal fats for cooking, setting them apart culturally and nutritionally within Japan.

Pork, in particular, holds a central place in Okinawan cuisine (as it also does in Sardinia, another Blue Zone). Most families raised pigs, chickens, and occasionally other livestock. Fish and seafood were also staple components of the Okinawan diet, in particular giant clams.

CLICK HERE for evidence

The so-called 'traditional' Okinawan diet with allegedly only 9% of protein [cf. Le Couteur et al. 2016] is mainly one of starvation, as it was registered as a post-war dietary snapshot in 1949 by the American administration, after the decimating effects of the war on livestock [Fisch 1988]. Prewar Okinawa had more than 100,000 pigs, but this was decreased to 2,000 after the Battle of Okinawa [Nashiro 2019].

If anything, Okinawa was not influenced by Buddhism and levels of pork and goat consumption were historically 'exceptional among Japanese food consumption' [Shibata et al. 1992; Poulain & Naito 2005], 'the islands of Okinawa and Jeju are well known for their pork food culture' [Lee & Hyun 2018], 'all families raised pigs, and chickens and sometimes other farm animals, such as goats' [Willcox et al. 2014], and 'animal fats were mainly used for cooking' [Okuyama et al. 1996].

Studies showed that centenarians in Okinawa ate twice the amount of meat as mainland Japanese centenarians [Kagawa 1978 ; Akisaka et al. 1996]. Among other ASF regularly eaten in Okinawa are fish and seafood, especially giant clams [Sho et al. 2001, 2008 ; Claus 2017].

Animal-sourced foods in Blue Zone diets

The Blue Zone argument disingenuously fails to acknowledge that good physical and mental health do not only correlate with the consumption of plants but also with certain animal-sourced foods. Studies have shown that dairy and/or moderate meat intake are independently associated with improved physical function in Sardinia and Costa Rica and with longevity in Okinawa, whereas a higher intake of animal-derived protein parallels improved mental health in Sardinia.

The intake of dairy, eggs, fish, seafood, and poultry can be substantial. In some areas, like Okinawa and Sardinia, red meat is a more integral part of the diet than often assumed. In Sardinia, centenarians are predominantly found among pastoralist populations rather than cultivators.

CLICK HERE for evidence

The Blue Zone argument overlooks that not only plants but also dairy and moderate meat intake are independently associated with improved physical function in Sardinia and Costa Rica [Nieddu et al. 2020], with longevity in Okinawa [Shibata et al. 1992], and a greater animal-derived protein intake possibly with mental health in Sardinia [Ruiu et al. 2022]. In addition to what is mentioned above for Okinawa, other Blue Zones also consume considerable amounts of animal source foods. This is the case for Costa Rica, where a majority of centenarians were found eating dairy and eggs daily, and fish and poultry several times per week [Chacon et al. 2017]. In Sardinia, centenarians are particularly found in pastoralist populations, not among cultivators [Pes et al. 2011]

List of key resources

Newman (2024) Supercentenarian and remarkable age records exhibit patterns indicative of clerical errors and pension fraud. BioRxiv.
Shibata et al. (1992) Nutrition for the Japanese elderly. Nutrition and Health.
You et al. (2022) Total meat intake is associated with life expectancy: a cross-sectional data analysis of 175 contemporary populations. International Journal of General Medicine.

Share this page on: