Foods Consumed by the Healthiest People
Part 3 – Sardinia, Italy

As I alluded to in parts one and two of this series (See Foods Consumed by the Healthiest People Part 1, Dynamic Chiropractic 2011;V__N__) it is very difficult to be as specific as I would like to (for a number of reasons discussed in Parts 1 & 2) when discussing what foods are consumed by people in areas known for extreme longevity. Below I will use direct quotes from sites that were representative of the scores that I visited while I tried to determine what the healthy people in Sardinia eat.

By the time this is published, the first anniversary of the Janurary 23 2011 death of our colleague, Jack LaLanne DC will be close. Dr. Jack lived 96 years and 4 months and, beginning at age 15, 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. Everybody 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 extreme longevity is that the people live long and healthy lives without trying. In fact, 4/5 identified longevity zones have no gyms, no supplements and no health food stores. Sardinia is one of those 4. It also has something that is not found anywhere else in the world.

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 line stating at least 220 of Sardinia’s current 1.6 million people have reached 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 where the United States has 12, 15, 18, 20 or 23 people per 100,000 residents reaching 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 September 14, 2011 that stated Okinawa has 66 centurions per 100,000. ( This does not make the 220 centurions out of 1.6 million in Sardina seem impressive, even though Sardinia is on everybodies list of longevity hot spots. Jump on the web and the most common quotes you will find for Sardinia are 13.5 centurions 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 reaching 100 in a given area. What is required is to determine this 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 1300 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.1, 2 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 100 at the same rate. Furthermore, the entire island - both the blue and non-blue zones have a female to male centurion ratio of under 2:1. To understand how unusual this is, consider that in Okinawa, where the life expectancy is the highest on earth, 803/920 centurions who were alive as of September 2011 were women. (
In a study that traced birth records from 1880 to 1900 researchers discovered that centurion rate was 264/100,000 births a century ago in the blue zone.2 using the more common formula of 100 year olds per 100,000 current residents, I still calculated 146/100,000, which is 7 times the highest published American rate of 22/100/000. The dark blue zone numbers were even more impressive since 91 people (47m, 44f) out of 17,865 births lived to be 100 for a rate of 509/100,000 births a century ago or a whopping 216 centurions 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 for a rate of 1080/100,000!3

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, the almost all of the people who reach their 90's 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 Do They 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 consist (ing) of zucchini, tomatoes, potatoes, eggplant and the fava beans....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....(that 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..."

"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 Centurions drink moderate amounts of wine...(that has)..has two to three times the level of flavonoids as other wines."

"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." 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." "The wine of Sardinia is a very dark, red wine called vino nero, which means “
black wine”. Wine is consumed with the meal."
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 5 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. 4 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.

1. Poulain M, Pes GM, Grasland C, Carru al. Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Exp Gerontol. 2004 Sep;39(9):1423-9.
2. Poulain M, Pes GM Grasland C, Carru al. Age-validation and non-random Spatial Distribution of Extreme Longevity in Sardinia : the AKEA Study. Unpublished draft from November 2003 available on line
3. Poulain, M. Pes, G M., Salaris,A . A Population Where Men Live As Long As Women: Villagrande Strisaili, Sardinia. Journal of Aging Research
Volume 2011 (2011), IN PRESS accessed 12-1-11. Article ID 153756
4. Pes, GM, Tolu, F, Poulain, M. et al Lifestyle and nutrition related to male longevity in Sardinia: An ecological study. Nutrition, Metabolism & Cardiovascular Diseases (2011) doi:10.1016/j.numecd.2011.05.004

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