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Dear Dietitian – what makes “blue zone” diets healthy?

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PICT Leanne McCrate Dear Dietitian
Leanne McCrate, RD, LD, CNSC

Dear Dietitian,

What makes “blue zone diets” like the Mediterranean diet so healthy --Chris

Dear Chris,

Blue zones are areas of the world where people live much longer than average. The term was trademarked by Dan Buettner who identified these five regions of the world: Sardinia, Italy; the community of Seventh-Day Adventists in Loma Linda, California; Ikaria, Greece; Okinawa, Japan; and Costa Rica’s Nicoya Peninsula.

The Mediterranean diet (MeDiet) is a type of blue zone diet and is traditionally followed by people who live along the Mediterranean Sea. It is a plant-based diet rich in fruits, vegetables, whole grains, nuts, fish, and olive oil. Red meat is eaten no more than once a week, and red wine is often enjoyed with meals. This diet is associated with lower rates of cardiovascular disease (CVD) than American diets. It replaces saturated fat with monounsaturated fat found in extra virgin olive oil and polyunsaturated fat found in nuts. It is likely the combination of foods in this diet that produces health benefits.

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In the PREDIMED study published in 2013 Journal of New England Medicine, over 7,000 participants were randomized to follow a MeDiet with added olive oil; a MeDiet with added nuts, or a low-fat diet in the control group. Participants were instructed NOT to reduce calories. The study measured the combined risk of heart attack, stroke, and death from cardiovascular (CV) events. Cardiovascular events were defined as heart attack, stroke, or death from cardiovascular causes. Those who followed the MeDiet with olive oil saw a 30% decrease in CV events, while the MeDiet + nuts saw a 28% decrease compared to the low-fat group.  

While diet is a major contributor to well-being in blue zone areas, it is important to note other significantfactors. These cultures also have an emphasis on faith, family, physical activity, no smoking, and no “time urgency.” Several ingredients go into a healthy lifestyle recipe.


Dear Dietitian

Leanne McCrate, RD, LD, CNSC, is an award-winning dietitian with over fifteen years of experience. Have a question?  Email Leanne at