 Welcome to the Dr. Gundry podcast. So what if you could unlock all the secrets of the longest living people on the planet? Well, I've got news for you. You can. On this episode, I'm gonna do a deep dive on blue zones. The five geographic reason, let's do that again. On this episode, I'm gonna do a deep dive into the blue zones, the five geographic regions that are home to some of the world's oldest but healthiest people and let you in on some secrets that could help you live the longest, healthiest life possible. And as the only nutritionist to spend most of their career living in a blue zone, I can tell you that these secrets are likely not what you are expecting. So don't go away. In a moment, I'm gonna bust some of the biggest blue zone myths, reveal my number one longevity booster when it comes to diet and share how you can set yourself up to live a long, healthy life, no matter your location. I'll also answer some of your most pressing questions on the matter straight from my Instagram. Okay, topic number one, what is a blue zone? So blue zone is a term that was coined and trademark by the journalist, Dan Butler. And it describes areas in the world that he visited that had some of the longest-lived people per percentage of population and the healthiest longest-lived people in population. And so those five places in the world that he described were Sardinia, Italy, hold that thought because it's actually only a part of Sardinia, the islands of Okinawa, Japan, the Nikoya Peninsula in Costa Rica, Ikaria, Greece, and Loma Linda, California. Whereas most of you know, I was a professor of heart surgery and pediatrics for most of my career. How and when were the blue zones discovered? Well, as I mentioned, Dan was a journalist for National Geographic and he was given the assignment to seek these places out. Now interestingly enough, since he first described these five places, there have been additional what I think we should consider blue zones that he did not visit or describe. And I've written about these in the longevity paradox. And one of them is the city of Attioroli south of Naples, Italy. And also the Katavans in Papua New Guinea. And I've mentioned both of those groups as well and we'll probably come back to talking about that. Okay, so let's get to the big question. What are people in the blue zones doing differently? Why are they living such long, healthy lives? Well, as you probably imagine, diet plays a huge role. But it's not actually as simple as you think. See, the blue zones actually have very wildly different diets from one another. So for instance, it is under a general impression that all of these blue zones owe their longevity to eating grains and beans. And in fact, that's absolutely, positively not the case. Let me give you the example of the Okinawans. The only true study of the traditional Okinawan diet was actually done by the U.S. Army in the late 1940s. And that was the last time, quite frankly, Okinawans ate their traditional diet. The Okinawans subsisted on a purple or blue sweet potato. In fact, 85% of their diet was this purple sweet potato. They had small amounts of soy in the form of fermented soy, which is not tofu. It's more tempeh and miso. And they had very small amounts of rice. And it wasn't brown rice, it was actually white rice. So when somebody says the blue zone gets their benefit by eating beans and rice, I can assure you that the Okinawans do not get the benefits of eating beans and rice. They get the benefit by eating purple sweet potatoes. Another great example, in my upcoming book, Unlocking the Keto Code, a real shocker that even surprised me, quite frankly, is that the Sardinians who do eat, quite frankly, a lot of buckwheat bread, and the Costa Ricans who do eat a lot of beans and corn, actually both the bread and the beans and corn in these communities are negative factors that are actually offset by spoiler alert, the large amounts of sheep and goat cheeses and yogurts that both these communities eat. In fact, some startling studies show that the Sardinians who have longevity live high in the mountains and comparing them to the Sardinians that live by the sea show there's no benefit in longevity in the sea-dwelling Sardinians, only in the mountain-dwelling Sardinians, and when we break down their diet, the difference is that the mountainous people in Sardinia are sheep and goat herders and get the vast majority of their calories from goat and sheep cheese. Now, I'm not gonna tell you the spoiler of what's in the goat and sheep cheese that makes a difference. You're gonna have to stay tuned for unlocking the keto code, but the same things happen in the Nagoya Peninsula of Costa Rica. It's the goat and sheep cheese that actually makes the difference in their health not the corn and beans. So, sorry about that. Interestingly enough, the acerolles of South Italy, they eat a diet composed almost entirely of anchovies, lentils, they don't eat pasta, they don't eat bread, they eat huge amounts of olive oil, and quite frankly, they have a considerable amount of wine, and so they also go against the grain, so to speak. The katavans don't eat any grains, they don't eat any beans, they subsist primarily on coconuts and fish and other vegetables. So, when we look at these supposed blue zones that depend on their health by eating grains and beans, I'm sorry, the evidence does not wash. In fact, even on Crete in Greece, a great huge benefit to these people is actually from a weed, a common weed, that you'll see growing in your sidewalks, called perslane. Many of you may know it as moss rows, it may grow it as an ornamental flower in the summer. The people in Crete eat so much perslane that perslane contains a very high amount of a short chain omega-3 fat called alpha-linoleic acid, and the famous study looking at the effect of adding alpha-linoleic acid to a diet of people who had suffered a heart attack and comparing it against the American Heart Association Low Fat Diet, the famous Leon Heart Diet, or many people know it as the Lion Heart Diet. The people who got the supplementation with alpha-linoleic acid, which is present in perslane, did so much better at avoiding new heart attacks that the study was stopped after three years as unethical to continue. So, the benefit that the folks in Crete got was not eating the breads and beans, was the fact that they were eating huge amounts of perslane, which was the benefit of that diet. So it takes more than just saying, oh, look, are these people eat grains and beans, and that must be it. In fact, there's far more nuance to study the blue zone that a physician can actually extract than potentially a journalist. Now, the other thing that I write about in the longevity paradox and the plant paradox is that there's been numerous meta-analysis of the Mediterranean diet. And quite frankly, the Mediterranean diet has beans and grains as a part of the Mediterranean diet. But when we do meta-analysis of which factors in the Mediterranean diet are beneficial and which are detrimental, it turns out that both grains and beans are detrimental factors of the diet that are offset by the positive factors in the diet, and that's copious amounts of olive oil, copious amounts of fresh vegetables, copious amounts of bitter vegetables, and of course, a rather generous amount of wine in the diet. So it's these factors rather than the grains and beans that are the amazing factor. The third thing I might add, having just got back from Italy, it turns out that Italians are, as a group, very suspicious of grains and beans, and they go through extreme measures to detoxify their grains and beans. They soak their beans, and it turns out that soaking starts fermentation. So when they soak their beans for 24 hours, 48 hours, they're fermenting their beans, which decreases lectins. Plus, they throw the water out every six hours and start again, and water leaches out the lectins, and then they cook them for extended periods of time. Many cultures, particularly in South America and India, always pressure cook their grains and beans before they use them. The other thing I learned talking with some chefs is that almost all wheat flour that is used to make pasta is actually treated with a sourdough starter to ferment it before making it into pasta or even pizza. So when we say, well, they eat spaghetti and they eat beans and they eat pizza not so fast, they're eating fermented grains and beans, and that can make all the difference in the world. And I've written about this in my books. Okay, what else do they do? Well, interestingly enough, as I've talked about in all my books, I think one of the real common denominators of the Blue Zones is that they have a very low animal protein intake. Not necessarily a low fat intake, but a low animal protein intake. All of the Blue Zones actually have very limited amounts of meat in their diet. And what meats do they eat? Well, for instance, the Sardinians and the Costa Ricans actually eat mostly lamb and goat as their preferred meat. The Okinawans actually eat very little amounts of pork, but they use pork fat. So it's not that they're eating huge amounts of chicken, for instance. They do eat red meats, but the amount of the meat is very small. Now, why is this important? There's multiple reasons. And I write about this in all the books. The first, I think, overwhelming reason is that we have a cellular sensor for energy availability, and it's called MTOR or TOR, the mammalian target of rapamycin. We now know it occurs in all animals, so some people call it the target of rapamycin. This sensor actually measures energy availability, and it's very sensitive to certain animal protein amino acids that are not very prevalent in protein sources of amino acids. And when we look at turning off MTOR, longevity is the result. And we've devoted several books to that, the upcoming book, Unlocking the Keto Code, dives even more. So one of the things that they don't use is actually a lot of animal protein. The second thing that I think is very important is that in general, animal protein can be turned into a potentially harmful compound called TMAO, and it's only in animal proteins that TMAO is generated. There's a new paper out today looking at the microbiome, breaking down animal proteins and making more harmful products that stimulate aggressive prostate cancer growth. And when researchers at the Cleveland Clinic looked at over 600 men with aggressive prostate cancer, they found that they had a unique microbiome that aggressively took animal proteins and certain animal fats and produced more of these compounds that actually stimulated prostate cancer to grow. So once again, if we're trying to live a long time, we absolutely want to limit the process of generating harmful compounds, generating, turning on mTOR, and so that really helps explain why the blue zones do have extended life. Interestingly enough, speaking of cheese, having been a professor there, half of the Adventist's calories come from eating cheeses. So if you want to take away anything from this lecture as a shock value, it turns out that eating cheese, particularly certain types of cheeses, may be one of the surprising health-promoting things that you can do and stay tuned. Unlocking the keto code is going to blow you away on how that works. Since we're talking about animal protein, people keep writing in and wanting to know about the carnivore diet. And I've certainly talked about this sometimes ad nauseam. Now, why do some people swear by a carnivore diet for a long life? Well, first of all, let's be realistic. There is actually no society that follows a carnivore diet that has longevity. There isn't one. Please show me one and I'll be happy to change my mind. But there isn't one. And there's again, reasons that I just mentioned why that's probably true. So if that's true, why does the carnivore diet work short-term for some people? And it certainly does work short-term for some people. I've had a number of patients who've had a very good response to a carnivore diet. But what a carnivore diet does is actually provide a elimination diet. You basically are eliminating all sources of lectins from your diet. And in doing so, you're going to actually probably have a good result. The problem with a carnivore diet, as I talk about in Unlocking the Keto Code, is you begin starving the members of your gut microbiome community that are actually going to contribute to your long life. And if you've already read the longevity paradox or seen it on public television, you'll know that it's actually the gut microbiome and what you feed them that's going to promote your longevity more than anything else. Okay, so does that mean you have to give up meat? No, absolutely not. The adventists in general are vegetarians. There are a number of vegan adventists. And there are a number of adventists who cheat, if you will, with chicken and fish. But the vast majority are vegetarians. And again, about 50% of the calories among the vegetarian adventists in Loma Linda actually comes from cheese, from the fat from cheese. So again, keep that in the back of your mind. Now, I personally describe myself as a veg aquarium. I get my animal protein primarily by eating mollusk and shellfish and wild fish. And I may have them several times a week. But most of the time I get almost all of my calories from vegetables and olive oil and nuts. And as many of you know, there are multiple studies in the blue zones that show that a leader of olive oil in Sardinia and in Greece is one of the biggest drivers of those societies having longevity. So don't be afraid of olive oil. Can you get enough protein by just eating vegetables? And the answer of course is yes. All of the largest animals on earth only eat leaves and grass. Sorry about that. You'll not see a gorilla eating burgers. Gorillas and horses have far more muscle mass than you and I will ever have. And all they eat is leaves and grass. So you can absolutely meet all your necessary protein requirements by just eating leaves and vegetables. Now, if you wanna have meat, please, please, please get the highest quality grass-fed and grass-finished meats that you can find. And there are actually many sources now on the internet to find them. There's a local source here in Southern California, Primal Plants in Temecula, California. They ship, they're a great bunch of young people and their efforts should be applauded. There are really good sources of wild shellfish, wild mollusks, wild seafood. Please do not be fooled when you see the term organic salmon or organic fish. They didn't follow these salmon around to see if they're eating organically. These are farmed salmon that are fed corn and soybeans that just happen to be organic. And sadly, these fish take those fats and don't make omega-3 fats. They make omega-6 fats, the harmful fats. So please don't be fooled by a restaurant menu. Okay, steak lovers, how much red meat is okay? Well, moderation is the key here. Remember, not only does steak and animal protein produce TMAO, one of these harmful compounds, but sadly steak and lamb and pork also have a sugar molecule that actually causes us to attack our own blood vessels. It's called Nu5GC. The good news is fish and chicken don't carry that molecule, they carry the same molecule that we do. Okay, let's turn to probably the most important factor in longevity, and that's fasting or time-restricted eating. Now, more and more, as you read each one of my books, you're beginning to realize that it's not as much about what you eat, but knowing Wendy that's probably in the long run, even more important. And we actually have to thank Dr. Campo from the NIH, Dr. DeCabo, I apologize, Rafael DeCabo, who really, I think, flipped our attention into thinking that calorie restriction, that is reducing the amount of calories we eat every day to 25, 30% of normal, is actually the key to longevity. What Dr. DeCabo and others realize, Dr. Mattson as well, realize that it's perhaps the timing of when we eat food, not the amount of food that's important. And those of you who've read the energy paradox know that Dr. DeCabo's work showed that if we could reduce the amount of time that mice were allowed to eat the food that they were given, it didn't matter the composition of the food they were eating. It mattered how short a time period they were allowed to eat every 24 hours. And this was recently reproduced in Italian athletes and that study showed that if Italian athletes were given the same amount of food and asked to eat it in a 12 hour window so that they were eating for 12 hours and not eating for 12 hours versus compressing that window to a six to seven hour window so that they were not eating for about 17 to 18 hours, the athletes who compressed their eating window, even though they were eating the exact same amount of food, lost weight, had improved exercise performance and perhaps most excitingly, they dropped their mTOR levels dramatically as Evans by dropping their insulin-like growth factor. Now, one of the unique things about super old people who are thriving is they run very low levels of insulin-like growth factor called IGF-1. And I measure this every three to six months in all my patients. And I can assure you that all my super old patients who are thriving, including a 97 year old gentleman who drove from L.A. to my office in Palm Springs this week to see me, his insulin-like growth factor sits at 48. He's bright-eyed and bushy tailed. He runs his company and he's 97 years old and he drove to see me. One of the keys is keeping your insulin-like growth factor low. Now, why is that important? Well, insulin-like growth factor, growth factor makes things grow. And sadly, there's very strong evidence that people who have elevated growth factors have much higher rates of cancer and live much shorter lives. Conversely, it's incredibly rare to ever see anyone with a low insulin-like growth factor develop cancer because there's nothing there to stimulate growth. So, fasting, time-restricted eating is one of the most powerful tools all of us have at our disposal to improve our immediate health, our immediate health span, how long we're going to remain healthy and our lifespan. In fact, extending Dr. DeCabo's work is that if we compressed our eating window, we would actually have 10 good years of life even if we ate the exact same number of calories that we do now, just compressing that eating window. And you're gonna learn more about that in the upcoming book, Unlocking the Keto Code. And I'm gonna give you some even easier tricks than we're in the energy paradox to pull that off. Now, a lot of people wanna know, well, what the heck do I do when I'm not eating? I know I'm going to get hungry. Well, as most of you know, during the winter from January through June, I don't eat breakfast and lunch. And I eat all my calories in a two-hour window from six to eight o'clock at night. So at 22 out of 24 hours, I'm fasting. Now, quite frankly, in writing Unlocking the Keto Code, I became so impressed with the research that is ongoing that now, actually starting about a month ago, I reverted back to only eating one meal a day even during the fall now. So it'll be about nine months a year that I'll be eating one meal a day rather than the six months a year because the evidence is so fascinatingly strong that this may be the one tool at our disposal to maximize our lifespan and L-span, the one tool. In other words, you can eat all you want, but you just need to compress that eating window. And if you're really looking for something as doable, a six-hour window is really great and work by Dr. Massen from Johns Hopkins and Dr. DeCabo suggests that a six-hour eating window may be your maximum spot. So what do you do when you get hungry? Well, there's exciting work that came out of China that I talked about in The Energy Paradox and in the upcoming book that if you give your gut microbiome prebiotic fiber, then you can absolutely give them what they want to eat and they will send messages to your brain postbiotics to tell you you're not hungry. So there's lots of great prebiotic fiber out there. I make a supplement, prebiothrive, that is eight different prebiotic fibers. And so if you're hungry, just have a glass of prebiotic fiber and you'll be in good shape. Don't want to use mine, grind up some flax seeds, grind up some psyllium seeds, get some and just mix that up. You'll do great with that. Now, who is fasting, say, for? The only people I really don't recommend intermittent fasting to is women who want to get pregnant and women who are currently pregnant and women who are breastfeeding because you really want to have calories for your child. And I've seen over and over again that women who restrict their calories or change their eating patterns, your sensors in your body think that there's a famine. And the last thing you would want to do is waste an egg when there's a famine going on. And I have a number of very thin women, many of them athletes who want to get pregnant and we increase their eating window, we increase their calories and lo and behold, a number of them are actually got pregnant and delivered successfully. So those are the folks that you really don't want to play around with this. Okay, now there are non-diet related factors that also characterize the blue zones. And these are lifestyle factors. One of the unique things about the blue zones in general is that they all live in hilly communities. And Loma Linda actually means beautiful hill. These people walk up and down hills. They walk against gravity all their lives. And just two weeks ago, I posted on Instagram, my wife and I visited Capri, the island off the coast of Naples, which is really hilly. And I was so impressed to see the number of people walking these hilly hills up and down the steps. There's one walk we did that has over 1,100 steps. And if you saw it on Instagram, I posted a gentleman, an elderly gentleman who walked, we were coming down the steps, walked past us. And I stopped and it was so amazing because it wasn't even huffing and puffing. And I can tell you it was steep. I stopped and turned around and he realized I was taking a picture of him and he waved at me. And this is the sort of thing that these people do all the time. When I was in Acciaroli two years ago, sheep herders, goat herders are up and down these hilly hills around the community. The same thing with the Sardinians, the same thing with the Okinawans. These are hilly communities. So the more you walk hills, the better off you're gonna be. The other thing that these people do is they garden. They work the fields. And gardening is a great exercise. Most of us don't like housework, but believe it or not, housework is great exercise. None of these people ever went to a gym. None of these people had machines in their house. These people worked against gravity. And I think that's one of the best examples of longevity I can give you. The other thing these people do is they're primarily farmers. And they wake and go to sleep with the sun. They follow their animals. One of the things I've learned having lots of dogs is that dogs work with the sun. And when the sun rises, my dogs, our dogs are in our faces going, let's go. When the sun is going down, the dogs look at you and say, hey, it's time to go to bed. And that's what these communities do. They work with the cycles of light. And getting the proper exposure to dawn sunlight and dusk sunlight as they talk about in Unlocking the Keto Code may be one of the hidden secrets to these long-lived societies. The other thing that they're not exposed to is blue light. We are constantly bombarded with blue light from our phones, from our computers, from our TVs, from the lights in our rooms, all the LED, all the fluorescent light. Blue light is one of the most damaging things to our eyes, to our brain that anyone's ever discovered. The other thing that these communities have is an incredible tight-knit social network. And I think the thing that impressed me most about the Adventist was that this tight social network coming together every Sabbath to meet having support groups. And interestingly, in these elder-based communities, elders are sanctified. They're held in incredibly high esteem. And so many of the elderly people I meet in these communities, they tell me that they know that they have to stay alive to teach younger generations the secrets. And they feel devoted to their community and they feel devoted to staying healthy and active and participating with the younger members of the community. And I can assure you that these people are not shuttled off to assisted living and nursing homes. They're multi-generational families, either living in the same household or living right next door to each other. And I think it's really one of the lost arts of longevity that perhaps we need to rediscover. So having a purpose in life, having a purpose to help your community, having a deep social network is the other big defining part of these blue zones. Okay, that's a lot of information, but I wanna get some of your most pressing questions about blue zones. The questions I'll be answering today come straight from Instagram. Okay, the first three questions are all anonymous. Number one, what surprised you most during your time in Loma Linda? How have you changed your lifestyle since living in one of the blue zones? Well, I think the sense of community, like I just mentioned, was one of the most striking things about living in a blue zone. The other thing that really surprised me is the amount of walking that was done in Loma Linda and the neighboring town Redlands where I live. And I actually took up hiking and running when I lived in Loma Linda, because I was so impressed with what people did. The other thing that shocked me, really shocked me, was the amount of dairy products, particularly cheese, that the people in Loma Linda ate. It actually, when I met with the nutrition group in our hospital, it just blew me away with how much cheese they at Venice eat. And you're gonna see why I think that's so important in the upcoming book. Second, many people living in the blue zones don't rely on taking supplements. Why is it that most people outside of the blue zone should take them? Well, there's a lot of really good reasons. First of all, these people don't live in depleted soil communities. Our soil is barren. It's been destroyed with pesticides, herbicides. There is no top soil in the United States. And our food has like 70% less than the vitamins and minerals than our corresponding food had 50 years ago. They don't have that problem. Their soil is living. And so all those important vitamins and micronutrients are present in the food that they eat. Plus, these communities have not been exposed to glyphosate. And these, which absolutely destroys the microbiome and destroys our ability to use nutrients. That's one of the exciting things when I go to visit these places. The other things that these communities do is they have a wide range of foods that they eat on a rotating basis. Now, most people in this country eat a very few forms of food. And a ton of our food, whether we know it or not, is derived from corn and wheat. And our corn is mostly genetically modified and our corn and our wheat is sprayed with Roundup. So we have absolutely no way of getting the vital vitamins and nutrients that these blue zones get on a routine basis. And that's why, at least for us in the West, supplementation makes so much sense and is actually so much needed compared to the blue zones. What are your thoughts on cultivating or growing a blue zone? Well, it turns out the blue zones as trademark, Adventist Health, have partnered with RPC legacies, hotel and residencies to begin construction of a flagship well-being and medical facility in Miami, Florida. And I really commend them on this. I think this is really an exciting thing to try. Recently, I've been approached to have a community in the Northwest partner to have a Gundry blue zone in that city. And we're just in the initial talks, but who knows? Very soon you might visit a Gundry community where this is going to take place. Okay, we'll have a lot of other questions on a next time we're gonna do this. They're really good questions, but I gotta wrap up for today. So thank you for sending those in to me. And like I say, we'll get to them as soon as we can. So let's move on to the review of the week. This review comes from Free Mandela. I was suffering from asthma for years. In the last four years were not easy. I tried to eliminate gluten, lactoceram. I was using my Hoover all the time, sleeping with special bed sheets. I did not try to sleep without them yet. 45 days of electing free diet and my asthma is gone. I don't even need to take my inhaler shots anymore. Modern classic medicine is always saying asthma cannot be healed. Well, now we have the evidence to say that this is not true. Dr. Gundry, I don't even know how to thank you. You are one of the very few people who has helped me the most in my life without a doubt. Well, thank you, Free Mandela. Unfortunately, we've been sold a bill of goods and our health is in our hands and it's in, quite frankly, the food we put in our mouth. And just this week on Instagram, I posted a picture with me and Adam, who came running across the parking lot in Palm Springs. He's a pipe fitter working on one of the buildings in my complex and check it out. Adam had such soreness in his hands that he couldn't work and he adopted the plant paradox three years ago. He and his wife and he says, oh my gosh, how do I thank you? He's working full time, take a look at him. He's radiant health and this is why I show up to work every day and this is why I do this because your health is in your hands and I'm here hopefully to guide you in making choices that you can live with literally and figuratively. So that's all for today. Thank you, Free Mandela and I'm Dr. Gundry and I'm always looking out for you. We'll see you next week. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher or wherever you get your podcasts because I'm Dr. Gundry and I'm always looking out for you.