The Blue Zone Distraction
Advocates of radical life extension are fooling themselves by focusing on the fake long-lived
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If you support efforts to make humanity immortal, I support you. But I want you to get serious. I want you to avoid citing studies that are little more to you than distractions. If you want humans to live much longer lives, please stop looking at purely correlational social science work that says—for example—people who get married live longer lives and thus marriage causally extends lifespans. To really extend lives, you have to get causal, and you will have to fund real, basic, nose to the grindstone scientific work that produces actionable advice, or you’ll end up distracted by nonsense long enough to die.
One major distraction for life extension advocates is geographical peculiarity. That is, regions of the globe that supposedly contain lots and lots of extremely old people, making those regions worthy of study to figure out precisely what allows them to harbor so many of the world’s longest lived individuals. The most notably peculiar geographical regions are known as blue zones:
When the discoverer of the five blue zones—Dan Buettner—was developing the case that they were worthy of special scholarly attention, he claimed they showed the oldest people were:
Remarkably inactive. They didn’t tend to be heavy exercisers, or even to exercise at all. Instead, these people tended to garden, knead dough, and use tools, because movement was a part of their daily lives rather than something they sought out.
Ritualistic. Blue zone inhabitants pray, they venerate their ancestors, they take siestas, and they drink at happy hours, regularly, to reduce the stresses of life.
Purposive. Blue zone inhabitants supposedly live more meaningful lives and know what their goals for living are.
Winos. Well, not exactly winos, but they apparently tend to drink wine or a bit of other alcohol regularly.
Plant-based. Apparently 95% of 100-year-olds eat only plant-based diets, with a heavy emphasis on being bean-based. It never was clarified if this is why they lived so long or a consequence of being so old, but that’s neither here nor there.
Thin eaters. The oldest old create strategies to preclude themselves from gorging on food and drink, and in the blue zones, people eat large breakfasts, smaller lunches, and minuscule dinners.
Lovers. Centenarians supposedly put a lot of work into their relationships and their kids often regard them as sources of wisdom to be kept in their lives.
Community-oriented. Blue zone inhabitants tend to live in faith-based communities and their religiosity is supposedly part of their exceptionally long lives.
Selective. Blue zone inhabitants cut unhealthy people out of their lives and curate healthy social circles filled with individuals who are unlikely to get them to do unhealthy things—they like thin, non-smoking, limited-drinking, socially connected, and happy people.
So there we have it: Buettner looked at blue zones, found things that made them unique, and now we’re all going to be able to live another three decades, right?
The problem is that blue zones are fake.
Italy
Buettner correctly identified that a disproportionate number of the super-old in Italy can be found in Sardinia. Here’s a per capita map for semisupercentenarians (≥105-year-olds):
As recently documented by Saul Newman, this is illusory. Exceptional lifespans in Italy predate the introduction of proper old-age recordkeeping. Across Italy, life expectancy at age 55 predicts life expectancy at each age from 60 to 95, but once you cross over into ages that came before quality birth certificates were introduced, the correlations tilt to being negative. Moreover, provinces with more unemployment, fewer people older than 90, and lower GDPs all have more of the extremely old. In other words, something is fishy, because this should not be how the correlations work out.
Thankfully, Italy’s clear statistical signals of irregular old age numbers are accompanied by news articles that reveal the rest of the story. Consider this one from 1997, entitled “Italy’s Dead Pensioners”. Nearly three decades ago, it was found that the Italian government was paying out pensions to about 30,000 dead people and cutting those people off would save the Italian government between $164 and $410 million per annum ($324-$811m today). Those dead people were disproportionately exceptionally old people from Sardinia.
Sardinia is not really a blue zone, it’s a fraud hotspot.
Costa Rica
The Nicoya blue zone is one that Buettner identified less as a home to the extremely old and more as a place with very high average lifespans, but he chalked that up to the wrong reasons. Consider that some 42% of Costa Ricans who were aged 99 and greater were people who simply misstated their ages in the 2000 census and a relatively simple reanalysis of the blue zone in Nicoya shrank its geographical area by about 90%, and the relatively old average ages seen in the zone failed to manifest in later cohorts that had proper birth documentation. Costa Rica as a whole has poor life expectancy after handling its documentation issues.
Nicoya, Costa Rica is not really a blue zone, it’s a place of ignorance.
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Japan
The story of Okinawa and Japan more generally is a remarkable one, because the reality of its old age population is now known, but that reality doesn’t seem to have had much of an impact on the demographic literature. Consider this 2010 New York Times story in which the reporter described how Japan had been hunting down its centenarians to little avail. Seriously, just read this:
Japan has long boasted of having many of the world’s oldest people, a testament, many here say, to a society with a superior diet and a commitment to its elderly that is unrivaled in the West.
That was before the police found the body of a man thought to be one of Japan’s oldest, at 111 years, mummified in his bed, dead for more than three decades. His daughter, now 81, hid his death to continue collecting his monthly pension payments, the police said.
Alarmed, local governments began sending teams to check on other elderly residents. What they found so far has been anything but encouraging.
A woman thought to be Tokyo’s oldest, who would be 113, was last seen in the 1980s. Another woman, who would be the oldest in the world at 125, is also missing, and probably has been for a long time. When city officials tried to visit her at her registered address, they discovered that the site had been turned into a city park, in 1981.
To date, the authorities have been unable to find more than 281 Japanese who had been listed in records as 100 years old or older. […]
“Living until 150 years old is impossible in the natural world,” said Akira Nemoto, director of the elderly services section of the Adachi ward office. “But it is not impossible in the world of Japanese public administration.”
The last part is not an exaggeration. In 2010, the Ministry of Justice put out a memo noting that there were 234,354 people aged 100 and older whose addresses were not recorded. Some 77,118 of them were older than 120 and 884 were older than 150. These people largely didn’t exist; in some cases, they never existed, and in others they were long dead, including many cases where these dead people’s pension checks just kept coming. A simple check shows that Japan’s centenarian numbers were off by over 80%. To make matters worse, Newman documented that Japan’s regions with the most outstandingly long-lived people were, like Italy’s, quite poor, and among the least likely to actually contain the very long-lived.
This is really incredible, because earlier publications either took Japanese numbers for granted as being real, high-quality proof of exceptionally long life and linked lifestyle factors, or claimed to validate those numbers, albeit indirectly, through methods that we now know to be faulty due to these revelations.
Okinawa and, indeed, the whole country of Japan are not really blue zones, the country is actually a place with concentrated pension fraud and missing old people.
Greece
Like Italy, Greece has struggled with the unfortunate reality of paying dead people lots of money. In 2012, it was found that almost three-quarters of Greek centenarians were either dead or pension fraudsters listed as having the wrong ages. As Newman noted, the Sardinian and Icarian blue zones were, respectively, at the 36-44ᵗʰ and 56-65ᵗʰ percentiles in the European Union for old-age (i.e., ≥85) longevity by official statistics. Couple that stat with the fact that Icaria is also poor and an area with above-average drinking, illiteracy, smoking, and low educational attainment, and the picture becomes like the picture in the other blue zones so far.
Icaria is not really a blue zone, it is a place that suffers from the same issues observed in the other supposed-but-not-actual blue zones.
California
In America, the number of recorded supercentenarians levels off right after states introduce proper birth records:
This is no mistake. It’s a strong indicator that like Japan, Greece, Italy, and Costa Rica, America too has botched records for its supposedly oldest old. The extent to which this is true is, unfortunately, pretty obvious. Simply comparing dates of birth in two plain-text record files brings the number of people born in 1900 without confirmed ages up to 12% at 100 years old, 17% at 105 years old, and 35% at ages 109 and older.
The supposed blue zone of Loma Linda, California is like the blue zone in Nicoya, in that it’s not really known for having the oldest old, it’s known for having an exceptionally high average lifespan. If you look at a distribution of life expectancy estimates for different census tracts including Loma Linda, you see a damning picture. The Loma Linda suburbs (green lines) have life expectancies ranging from the 27ᵗʰ to the 75ᵗʰ percentiles of life expectancy at birth for the U.S. as a whole. Even the female-only life expectancy provided by proponents of the Loma Linda blue zone theory (light blue line) is not that high, at the 98ᵗʰ percentile for the U.S. as a whole, putting it behind 1,401 other U.S. census tracts and the countries of Japan, Singapore, Monaco, Spain, and South Korea.
There is no “Loma Linda blue zone”, there’s a place that is probably not all that exceptional for living a long life.
An Appeal
If you want to succeed at giving humans longer lives, we must obtain better data. Places like the blue zones don’t have an especial relevance to longevity, and focusing on them will tend to be a waste of time that distracts from other, more important work. The faultiness of the data from these and other places will also tend to make the search for longevity secrets all the more difficult because, for example, due to this sort of error, we don’t really know the shape of late-life mortality, and we certainly don’t have great ideas about the sorts of health behaviors that sustain the longest possible human lives.
If you are interested in discovering what really makes people live longer lives, cast aside the lessons of frauds and capitalization on correlations, and focus on doing the basic science that will finally, ultimately banish death. If we fail to do that, then death will surely come for you.
https://youtu.be/J4AAWiNAE8Q?feature=shared
Above is a yogurt commercial that claimed Soviet Georgians ate lots of yogurt and lived a very long time. After the USSR failed they looked into this and these guys were draft dodging young men who assumed fathers or uncles identity in WW2. Smart. You can get hurt in a war.
I have worked with US Social Security Administration and Medicare data since the late 1990s. This is a phenomenon that is well-known inside the gerontology research community but little discussed outside -- and all the US data are polluted, not just Loma Linda. There is a group of SSA/Medicare beneficiaries that we colloquially call "the immortals" because they 'refuse' to die on paper. How to account for them in health services and chronic disease research is an ongoing problem.