Discussion of blue zone diet (spin-off from "why not lift weights")

I was considering spinning off a thread to return to this … but I don’t follow.

Yes we’d expect more of the outliers to be in sparsely populated communities. But the observations of Blue Zone are not what we’d expect if it was a random selection of those sparsely populated rural areas. Most of those area are not filled with people eating and living Blue Zone. They are sitting on their asses eating junk.

So why don’t any of those communities end up having many over a hundred?

As I said in the last paragraph, it is unlikely that one of the regions that was selected by the Blue Zone analysis would be doing anything particularly horrible. If you have too many bad things, those will balance the good and drop you into the norm. If we assume that diet makes a significant impact on longevity, then their diet must not be terrible. But, that’s an assumption.

Let’s say that we know through science that the important thing that a person can choose to do in their life to stay healthy is to eat a well-balanced diet and get exercise of different intensities.

In a few regions in the US, maybe the rural, small farm regions eat like trash. But, across the entire planet, most rural, small farm regions are going to have a lifestyle of eating a well-balanced diet of whole foods and getting exercise of different intensities working on the farm.

So we have 90% of rural, small farm regions that are doing the right thing and they should be topping out the scale. But, in practice, only a few are. Okinawa is doing well but those small farm regions in Ghana are doing crapy. What’s different? Farm exercise is probably equivalent between the two so - since we’ve limited our view to food and exercise - the answer must be the food…right?

Okinawa’s secret could be purple potatoes, sure. But it could also be that Okinawa is part of Japan - a first world country with modern medicine, indoor plumbing, minimal poverty, minimal violence, etc. and Ghana is not those things. It could be that Okinawans have good genetics, that they suffered a life extending period of famine, etc.

We could imagine that plants native to Western Africa might be more healthy and life extending than the plants native to Okinawa. Maybe chufa, elephant ear (plants), goat, and breadfruit are a better diet for longevity than purple potato, fish, mizuna, and pickled daikon. Likely, pickled foods undo high antioxidant foods, if nothing else. But, between smoking, violence, a life of dysentery, HIV, poorly insulated homes, and bad genetics, Ghanaians live shorter lives despite their healthier diet.

The reality on the ground might be that the Ghanaian diet is healthier than the Okinawan. Okinawa jumps to the top of the pack not because of their diet but because of other factors - governance, economy, technological development, WWII, etc.

So should we eat chufa or purple potato? One is devoured by people who die young and the other by people who die extra old, and that’s not nothing, but that’s sort of a nonsense comparison when you’re comparing people with indoor plumbing and electricity to people who live on a dirt floor and smoke hashish like chimney pipes.

A random selection of regions, looking for any statistical anomaly will give you a territory of small farms. In terms of lifestyle, the norm will be eating whole foods and a good amount of exercise. The specific vegetables that they eat could be the differentiator. But it’s also possible that the differences in whole food diets, from one region to another, is largely negligible. Maybe you eat blueberries (antioxidants, yay!) and spinach (oxalic acid, boo!), and they cancel each other out. Maybe Okinawans eat purple potato (antioxidants, yay!) and pickled foods (nitrates, boo!) and those cancel each other out. For almost any regional diet, for any “good” food there’s also an equally bad food, also in the diet. After all, these foods weren’t chosen to be life extending, they’re just what grows natively in that region and the people were going to eat whatever that is, so long as its effects aren’t immediately worrisome. Between the dozens of things in a regular human diet, there’s too much variety for any one good or bad thing to really pull ahead, until you exit the realm of whole foods and start looking at regions with ultra-processed foods. Then you can get a diet that does something significant (in the negative direction).

It’s certainly true that Okinawa has more long-lived people per capita than the normal. But, if that’s because of genetics, WWII, plumbing, or whatever other thing then that’s not useful to us when we’re looking at diet. Knowing that they live longer doesn’t tell us what the cause was. Taking the assumption that it’s that one thing in their diet doesn’t make it so. It may be, but it also might not be.

Hate to be that person but “cite please”? I’m thinking you are mythologizing some image of life on the farm that is not the actual life of a majority let alone 90% of those who live in rural areas (which is not btw required to be small farms)

It doesn’t seem to the case in India for example.

In much of the world rural residents are not having an opportunity to eat the right food as they often cannot afford it. Junky food is cheaper for them too.

I’ve traveled to India and worked alongside a pretty good number of Indians but I don’t know that I’d go so far as to claim expertise on the subject.

In general, though, I’d be a bit skeptical of the headline. Saying that there isn’t a large difference in diet and lifestyle between rural and urban dwellers isn’t the same thing as saying that rural folk are eating a diet of potato chips and bacon and spending 90% of their time at a desk.

As best I can tell, they are basing physical activity on foot steps. (WHO STEPS physical assessment) If I’m sitting on a tractor, pulling weeds, I’m getting zero steps but I’m not physically inactive. If I live in the city, delivering rugs from the factory to various shops, I’m a city dweller but I’m not a desk jockey.

Walking is a large element of living in an Indian city and, I suspect, the average occupation in an Indian city is far more active than the average city job in the USA. There are certain cities like Bangalore that are stronger on tech and maybe have more people sitting behind a computer. But even Bangalore, to my eye, looked a lot more like you’d imagine ancient Rome or Arabia than like Seattle. It’s not a place of inactivity. I’d imagine that other Indian cities are even further removed from the US norm.

All Indians that I have worked with ate home made meals, using traditional recipes, cooked from whole foods.

A person who works on a dairy might have plain yogurt made straight from their own cows. I might eat an equivalent amount of strawberry yogurt, that I got from a plastic container at the supermarket. We both got a serving of dairy but they’re not equivalent servings.

If I lived in a country that hadn’t yet discovered the miracle of putting extra sugar in every product, then the yogurt that the dairy worker eats and the yogurt that the city dweller eats will end up truly the same.

I’ll respond and if this discussion requires more I will in my next response try to create a se page thread to avoid excessive hijacking.

I am puzzled by the foods you define as “bad” but I pull this out not to dispute those but more because it seems you miss the complete point of the Blue Zone thing.

The point is not specific foods; really the opposite. It is that there are common themes and patterns in these zones even as they vary in the specifics. The specifics illustrate the pattern.

They are all “plant forward” with no more than a modest amount of red meat in particular, lots of vegetables, fruits, and whole grains. They are communities with more than average social connectivity, and none have huge amounts of being sedentary.

These patterns are not what you’d expect to see from random outliers of rural communities across the world.

The relatively higher pork and white rice diets throughout rural China, even if homemade, are not populating the very top list. No communities high in refined carbs or high in red meat does. It is not only the evil of hyperprocessed foods, though of course no communities high in highly process foods is there either, and there is plenty of rural communities high in that as well.

And again other lines of evidence also support the value of those broad patterns.

Again, if you believe it is then please provide evidence of such.

I think that you’ve misunderstood something. Saying that something isn’t methodologically sound doesn’t mean that it’s wrong.

For example, we know that a perfectly fair coin will - on average - land on heads and tails an equal number of times.

To demonstrate that, I could flip a coin n times and record the ratio of heads to tails, then do it again n x 10 times, again at n x 100, etc. and show that the numbers are converging on a 1:1 ratio.

But I could also go onto the internet and find photos that show a collection of coins, half face up and half face down, document those, and use them as examples of the equal divide in results of coin flipping.

The right answer is that a truly fair coin will land equally true and false, over an infinite number of flips. That’s going to be true regardless of which method we use to demonstrate it. But only one of those two methods of demonstration is methodologically sound.

Such is not the case.

The Blue Zone lifestyle information is not solid proof of anything as something standing on its own. Very little in science and more so in medical science is. We frequently have to be wary of correlations that are not causation and interpret with caution. The criticism you make of its methodology is however not valid. It is based on ungrounded assumptions about, fantasy images of, lifestyles in rural communities across the world. And/or possibly misunderstandings about the messaging regarding the findings.

As part of various corroborating lines of evidence put together the Blue Zone data is strongly supportive of certain patterns of behaviors being associated with a longer healthspan. If Blue Zones included groups that were very low carb red meat forward or high refined carb or not well socially connected then it would have been a significant finding towards falsifying the extant hypothesis about what many think is “healthy” as patterns of behaviors.

What I’d like to see as follow up is a search for other communities that fit those patterns of behaviors and seeing if consistently those communities tend to have above average healthspans.

The latter, possibly. All news articles that I have seen about it seem very focused on super-centenarians and diet/exercise. If someone’s living to 100 then their diet and activity level is what you should strive to replicate. If there’s a more complicated variant of the theory, then I’m willing to be educated. I wouldn’t consider that a good methodology. Yes, the people identified are going to be doing good things in terms of diet and activity level but, likewise, if I find that someone has perfectly flipped 4 heads and 4 tails, that doesn’t mean that they’ve done something specially good in the realm of coin flipping that I need to note more strongly than other people who flipped 5 heads and 3 tails.

But the former, I think you’re largely misreading me. If I make a statement like, “Let’s say that fruit are bullet proof, then your average fruit vendor is going to be less likely to die due to gang warfare.” And then you reply, “You clearly have a fantastical idea of fruit.” Well, no, I’m aware that fruit aren’t bullet proof. But I never said otherwise, I said, “Let’s create an imaginary world where this is true.” It is, by definition fantastical. It’s an explicitly designated imaginary world.

Hypotheticals are created to illustrate paths of consideration, they’re explicitly reality. Having them be closer to reality makes them a bit more easy for people to follow. It’s easier to imagine that a sheet of metal is bulletproof than a fruit is…but even several inches thick of metal can be blasted through by a sufficiently energetic bullet. It’s a hypothetical, regardless that most readers will find it easy to visualize. But the person who comes in and complains that there’s no such thing as “bulletproof metal” is misreading the discussion. They’re focusing on the wrong thing, and not taking in the intended message.

(Note, in this case there is no message to be taken away from the idea that a fruit can be bulletproof. But we’re assuming that someone wouldn’t throw the idea in to the discussion as a hypothetical without cause.)

Media of course has its own agenda, clickable being the main goal. And of course it gets used to promote what bottom line are very unsurprising recommendations. But I’m a good story sort of way.

I’ve read that post several times and still can’t follow what has to do with your complaint about it so I’m giving up.

I will state that there are valid issues to be raised. Some question the reliability of the life span data. A very good first explanation for outlier results is simply that the data is bad. That may be true for some of these communities.

The absence of the sort of follow up I was suggesting, looking for communities high on Blue Zone metrics and seeing if they also have above average health and lifespans, is also an eyebrow raise for me. It seems a natural thing to do.

Certainly serving a Blue Zone diet with several grains of salt is reasonable even though it makes recommendations that are supportable through other lines of evidence.

Nah. Too much sodium. Leads to heart attacks.

(I kid, I kid. But as a person who eats a lot of red meat, I’m not convinced it’s bad for me)

A lot of people want to live a long life provided one remains healthy, happy, functional and without severe problems including mobility issues, pain or severe physical or mental compromise.

Looking at regions where people live longer makes sense. Choose your parents well. But the best available research says only 15-30% of lifespan is due to heredity. Epigenetics seem to matter, as does diet and social life. The book Lifespan is a great, no BS, science based introduction to many of the relevant issues.

The Longevity Solution is a very good popular book on the subject, mostly decent information, some hype, slight salesmanship. It discusses Buettner’s zones, namely Okinawa, Sardinia, Ikaria, Loma Linda and Nicoya. And it rates them according to things thought by the authors to help: caloric restriction, mTor, polyphenols (concentrating on coffee, green tea or red wine), high salt and healthy fats.

It is a pretty simplistic view, not really including exercise, smoking, social factors or the latest research on diet. But it is reasonable for a popular approach. One of the authors is big on increasing the amount of salt in the diet to stay healthy. Makes some reasonable arguments, to my mind, though clearly is very selective in which studies to ignore and which to overemphasize.

Personally, I do not think red meat, eggs, full fat dairy or moderate amounts of salt are particularly unhealthy for many people - especially if they also exercise routinely, are metabolically healthy, and use some other additional forms of mitigation including adequate sleep, stress control, social life, avoiding some bad habits (smoking and excessive daily sugar), and consuming whole fruits and vegetables and adequate fibre.

And of course there is the confounded confounder.

Very often complete dietary patterns lower in red meat make up the protein with fish and/or plant sources (including beans seeds and nuts), and those high in red meat very frequently are not so ample in those foods.

Lowering red meat by replacement with high simple carbs or highly processed meat substitutes is a poor trade off.

Generally something going up means something else going down …

I agree, to a large extent, but don’t view nutrition in terms of zero-sum game theory. Macronutrients matter. Simple substitutions have often failed to provide spectacular nutritional benefits (Snackwells, fancy highly processed vegetarian burgers, etc.). Eat more beans.

But there is probably too much focus on proteins and cholesterol. There is probably insufficient focus on fibre and polyphenols. Hopefully we know much more about the gut microbiome and individual variations in a few years than we do now and can put nutritional biochemistry on a firmer scientific pedestal.

I also think there’s an element of puritanism. If your actions aren’t virtuous, they can’t be helpful. I’m really curious to see what the data will say about the new weight loss drugs (which aren’t virtuous, but might be good for many people’s health.)

The one popular review of the “blue zone” that i read said it’s not just about diet and exercise, but also about social connections, low stress, and getting enough sleep.

Well other than by way of different impacts on satiety it really has to be a zero sum game else there is a caloric excess.

The point I made though is not proscriptive; it is descriptive. Those who eat lots of meat tend to eat less legumes etc. and visa versa. On the one hand proving if it the decrease of one or the increase of the other is hard to do. OTOH does it really matter which one?

Well it is consistent with what we already have good evidence for about the importance of social connections to health and the devastating impact of loneliness (which to be precise is not the same as isolation.)

Sure, you need a minimum amount of calories, proteins, etc. to function and feel full from whatever sources. So you gotta eat something.

Of course, Americans generally just get the absolute minimum number of calories needed to do that (with Canada a close 4th place), which is why the covers of Newsweek are always complaining about the number of highly muscled citizens.

I’m very confused or perhaps I am expressing unclearly. “Eat more beans” does not happen in isolation is all. Either you eat all of everything else and add more beans (and of course then more calories), or you displace other intake.

Usually those who significantly “eat more beans” displace other things, and have diets relatively lower in red meat and simple carbs.

It’s a dietary pattern and one that seems to be associated with positive health outcomes, along with not being sedentary and having strong social connections. Is it more what is less, what is more, or both? It is hard to say.

Yes. Because diet is not a zero sum game. My daughter changed her drugs and gained about 30 pounds in a couple of weeks. She was in her late 20s, and fully grown. Her diet didn’t change significantly over that time span. I assume her metabolism changed, or the motility of her gut, or something.

Yes, on a macro scale, if you eat a lot fewer calories than you need, you will lose weight, and if you eat a lot more calories than you need, you’ll probably gain weight. But there’s a lot of wiggle room in there.

A lot of people still believe everything is due to calories. This is clearly an oversimplification.

People are not bomb calorimeters. We don’t absorb 100% of most foods, and we don’t combust them in closed systems. Eating protein is not the same as eating proteins and fibre together. The role of the gut microbiome and its specific role in digestion seems pretty significant and seems to vary immensely. The body is usually pretty good at using what is available but likely has no specific historical imperative to be as lean as possible. Many other inputs matter, though even copious exercise does not overcome a bad diet, especially as the years accumulate.

Given that you include the phrase “than you need”, no, there is no wiggle room at all.

No @Dr_Paprika we are not bomb calorimeters.

But that has zero to do with what I was saying.

Let’s discuss not the macro populations to make it simple.

A specific individual exercises a specific amount eating a certain amount of animal protein in meat centered diet which has a certain amount of calories.

They now “eat more beans”. Beans have a certain amount of net calories absorbed after digestion and net of the energy cost of digestion (thermic effect of food). What will happen?

Most of the time they will automatically eat less other food. (Maybe by a greater amount than the displaced calories even as bean have high satiety and impact on the micobiome that impacts intake over time but ignore that. Assume equal impact on satiety and microbiome.) It won’t be the result of counting calories.

Or, theoretically they could just eat the same of everything else do the same of everything else including exercise and non exercise activity and eat more calories than they need. In that hypothetical they would gain weight.

The latter rarely happens.

Populations that eat more beans tend to be populations that eat relatively less of something else, and most often that something else is red meat and often simple carbs.

And from various lines of evidence, not just the Blue Zone stuff as good of a story as that makes, we find those populations do well on a variety of health metrics. I suspect the benefits are more from the positives of the beans than from the decrease of the meat but it is hard to know how much each contributes. The less red meat likely contributes some.

This is not a very complex concept: one variable does not, cannot change in isolation, even in some imaginary controlled study. Increase beans as the variable and you either decrease other foods or increase calories.

Now let’s look from the other direction, which is why the phrasing of your directive IS useful. An individual decides to eat less red meat. They are going to eat more of something else. Automatically. Not because they calorie count. If they replace the meat with highly processed foods high in added sugars and unhealthy fats or simple carbs then any possible benefit of less red meat is I suspect swamped. Real world likely calorie count goes up as those foods have less satiety than red meat does. If they instead put more fish vegetables fruits whole grains legumes nuts and seeds into their diet to the point of satiation, even if it was the same calorie count (likely not, likely less) they are instead healthier.

Less red meat in isolation matters less than the pattern of the whole diet that it travels with. In the wild.

Exercise. Connect with family and communities. Eat more beans nuts and seeds. Eat lots of vegetables and fruits and complex carbs. Eat a fair amount of healthy fats such as olive oil and fatty fish. And stop eating when not hungry. Lots of those foods has to come from eating less of something. Will come from eating less of some things. Don’t focus on the less though. Focus on what is more.

Is high amounts of red meat harmful? Don’t know for sure. But large amounts of that other stuff is healthful and there is room for it by eating less red meat.