Foods Consumed by the Healthiest People, Part 3: The Sardinian Diet

As you read this article, the first anniversary of the Jan. 23, 2011 death of our colleague, Jack LaLanne, DC, grows near.

Dr. Jack lived 96 years and 4 months; beginning at age 15, he dedicated his final 81 years to living a long, fit and healthy life. When I was growing up I remember him referred to as a fitness freak and a health-food nut who (on TV) seemed to live on blended concoctions that washed down handfuls of supplements. Everyone now knows that his "abnormal" behavior paid off, and that he was years ahead of medical science.

What I find so interesting about the areas of the world where people experience extreme longevity is that the people live long and healthy lives without trying. In fact, four of the five identified longevity zones have no gyms, no supplements and no health-food stores. Sardinia, Italy, is one of those four. It also has something that is not found anywhere else in the world.

As I alluded to in parts 1 and 2 of this series [Sept. 9 and Dec. 16, 2011 issues, respectively], it is extremely challenging to be as specific as I would like to (for a number of reasons, as previously outlined) when discussing what foods are consumed by people in areas known for extreme longevity. In this article, I rely on some direct quotes from Web sites that are representative of the scores I visited while trying to determine what healthy people in Sardinia eat.

Sardinia: A Longevity Hot Spot

Sardinia is an island located 190 miles off the west coast of Italy. It is around 130 miles long and 70 miles wide. It was one of the first longevity hot spots known as a "blue zone" prior to the publication of the popular book with the same name by Dan Buettner. An often-quoted factoid contends that at least 220 of Sardinia's current 1.6 million people have reached the age of 100, twice the average of the rest of the world.

However, don't try to compare numbers and statistics, because if you do you will discover it is a convoluted, inconsistent mess. In researching this series, I read that the United States has 12, 15, 18, 20 or 23 people per 100,000 residents who reach the age of 100. In Okinawa, the most commonly repeated statistic you will find on the Web is 34 per 100,000. However, I found an article from a Japanese newspaper dated Sept. 14, 2011 that stated Okinawa has 66 centenarians per 100,000.1

This does not make the 220 centenarians out of 1.6 million in Sardinia seem impressive, even though Sardinia is on everyone's list of longevity hot spots. Jump on the Web and the most common quotes you will find for Sardinia are 13.5 centenarians per 100,000 and 22 per 100,000 (which may also be written as 135 or 220 per million.) When I realized the first number is for people born 100 years ago and the second number is for the current population, it hit me that while this statistic makes an interesting country-to-country comparison of current 100-year-olds, it does not reflect the actual percentage of people reaching age 100 in a given area. What is required is to determine how many other people were born 100 years ago in the same regions or nation.

In Sardinia, most of the northern half of the island is a longevity zone. Within it lies a 1,300 square-mile mountainous region on the east side of the center of the island where longevity rates are twice that of the rest of the island and 10-20 times that of the United States.2-3

What is even more unique is that the zone within the blue zone (a "dark blue zone") is the only place on Earth where men and women reach age 100 at the same rate. Furthermore, the entire island both the blue and non-blue zones have a female-to-male centenarian ratio of under 2:1. To understand how unusual this is, consider that in Okinawa, where the life expectancy is the highest on Earth, 803 of the 920 centenarians who were alive as of September 2011 were women.4

In a study that traced birth records from 1880 to 1900, researchers discovered that the centenarian rate was 264/100,000 births a century ago in the blue zone.3 Using the more common formula of 100-year-olds per 100,000 current residents, I still calculated 146/100,000, which is seven times the highest published American rate of 22/100,000. The "dark blue zone" numbers were even more impressive, since 91 people (47 male, 44 female) out of 17,865 births lived to be 100 for a rate of 509/100,000 births a century ago or a whopping 216 centenarians per 100,000 current residents. And in one village, birth records from 1876 to 1912 showed 16 men and 14 women reached their 100th birthday a rate of 1,080/100,000!5

Before we discuss food, it must be noted that there are many factors besides food that contribute to a long and healthy life. In Sardinia, like Okinawa, almost all of the people who reach their 90s and above do so as both physically and mentally functional members of society who can take care of themselves, like Dr. LaLanne did, and live long, quality lives until the end.

What the Sardinians Eat

"The thing that might surprise you at first is that these people in the Barbagia region do NOT eat a Mediterranean diet ... this does not, however, mean that they eat a lot of meat. Meat is usually served on Sundays and at festival times. But they do eat a lot of cheese, especially pecorino cheese made from their sheep's milk. ... The rest of the diet is mainly made up of fava beans, bread and the vegetables they raise .... mainly [consisting] of zucchini, tomatoes, potatoes, eggplant and the fava beans."6

"The wine is made from Cannonau grapes grown in the area. Given the location, apparently these grapes produce more red pigment which translates, when made into wine, into a beverage with high quantities of flavonoids. ... They drink goats' milk daily, [which is] extra healthy [due to] a plant they [goats] eat called Sardinian dwarf curry, which has anti-inflammatory and anti-bacterial properties. ... The last elixir of life is the mastic oil used ... residents use it instead of olive oil."6

"The typical Sardinian diet contains beans, whole-grain breads, fruits, garden vegetables, and in some parts of the island, mastic oil. Mastic oil is derived from an evergreen shrub originating in the Pistachio family. ... Most Sardinian [centenarians] drink moderate amounts of wine ... that has two to three times the level of flavonoids as other wines."7

"The Sardinian diet is a balance of healthy nutrients, fresh locally grown foods prepared simply with olive oil, lemon and garlic to compliment dishes. Meals are served in small courses usually with a pasta or soup first, a main dish with a focus on plant-based foods such as vegetables, legumes, and nuts, and ending with a salad to aid in digestion. ... Meat intake is low in Sardinia, typically only once or twice a week. When meat is eaten, it is generally regional and consists of lamb, lean pork, oily fish, and shellfish."8

"Farms in Sardinia grow many different fruit and vegetable crops, including tomatoes, oranges, figs, apples, apricots and grapes. Artichokes (carciofi) are a regional favorite and eaten in the winter season. ... Desserts are primarily a little cheese and fresh fruit. The cheese, called Pecorino, is made from the milk of grass-fed sheep and is high in omega-3 fatty acids. There is another type of cheese, called Cazu marzu or rotten cheese, which contains live maggots that ferment the cheese. Sardinians eat this because they feel the bacteria are good for the gut; however, it is considered illegal, and can only be purchased on the Black Market."8

"The wine of Sardinia is a very dark, red wine called vino nero, which means 'black wine.' Wine is consumed with the meal."8

I did find one study that compared selected foods consumed between men in the blue zone and men in the rest of Sardinia. Both groups ate meat five times a month. Men in the zone ate less wheat, more barley, more cheese and drank less wine. Nut consumption in the blue zone was a scant 10 ounces a year. Almost no nuts were eaten by the rest of Sardinian men.9 I wish the researchers would have included more foods in greater detail, but in the world of extreme longevity, food is seldom the primary focus.

By G. Douglas Andersen, DC, DACBSP, CCN

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