In the early 2000s, Dan Buettner embarked on a mission to determine what specific aspects of lifestyle and environment help humans live longer. He teamed up with National Geographic and the National Institute of Aging on his quest, and through research, they were able to identify five areas with the highest percentage of centenarians (i.e. a person who is 100 years old or older).

Known as the Blue Zones, these areas also have low rates of chronic diseases including heart disease, diabetes, and cancer. Buettner and his team of anthropologists, epidemiologists, and researchers traveled to these particular areas to study the lifestyle characteristics of the people who lived in these Blue Zones. From there, the “Blue Zone” diet became of interest to help people outside of these locations practice that way of life. Here’s everything you need to know about the Blue Zones, including diet recommendations and more.

What are the five specific locations of the Blue Zones?

1. Sardinia, Italy: Sardinia is the second-largest island in the Mediterranean Sea and home to some of the world’s longest-living males. The local shepherds walk at least five mountainous miles daily and follow a predominately plant-based diet. Meat is enjoyed on Sundays and special occasions only.
2. Okinawa, Japan: The world’s longest-living women are from Okinawa, a chain of islands in Japan. Their longevity is suggested to be in part due to their close-knit social circles, as well as an old Confucian mantra said before meals that reminds them to avoid overeating and stop when they are 80% full.
3. Loma Linda, California: The residents of this city in San Bernardino have one of the highest rates of longevity in America. The community of Seven-Day Adventists in Loma Linda follow a primarily vegan diet and also recognize their Sabbath day weekly.
4. Nicoya, Costa Rica: The Nicoya Peninsula is known for elders with a positive outlook on life. Their diet is abundant in tropical fruits packed with antioxidants, and their water is rich in calcium and magnesium that helps to prevent heart disease and builds strong bones.
5. Ikaria, Greece: This island in Greece is known for the long-living locals who embrace a Mediterranean diet abundant in olive oil, fruits, vegetables, whole grains, and beans. Ikarians also take time for a mid-afternoon break. They experience half the rate of heart disease and 20% less cancer than Americans do. Additionally, most Ikarians are Greek Orthodox Christians that follow several periods of fasting throughout the year where they essentially follow a vegan diet.

What habits contribute to the Blue Zone lifestyle?

Although the Blue Zones are all over the world, they share quite a few commonalities. After studying the Blue Zone populations, Buettner and his team narrowed down nine evidence-based common denominators among all of the world’s centenarians. Known as the “Power 9,” these factors are said to be the most influential in promoting longevity in these Blue Zone groups.

1. Move naturally: Centenarians don’t run marathons or frequent the heavy lifting section of the gym. Instead, they are just constantly active throughout the day by tending to their gardens, cooking, doing house work, and walking. Research on Sardinian men specifically found that residing in mountainous areas, walking longer distances to work, and shepherding are linked to their longevity.
2. Purpose: Blue Zone natives have a keen sense of purpose which motivates them in every day life. Ikigai and plan de vida are phrases from the Okinawans and Nicoyans, respectively, and both translate to, “why I wake up in the morning.”
3. Downshift: Stress is inevitable wherever you live, but centenarians take time each day to de-stress whether it’s praying, taking a nap, or enjoying a glass of wine. 
4. Eighty percent rule: The Okinawan phrase hara hachi bu is said before meals to remind Okinawans to stop eating when they are 80% full. This plays a role in weight management as well and fighting off obesity. 
5. Plant slant: Fresh produce, especially homegrown, and beans are the cornerstones of most diets of Blue Zone people. On average, meat is only eaten five times per month in the Blue Zone regions.
6. Wine: Most Blue Zone people, except Adventists, drink 1 to 2 glasses of alcohol per day with friends or at a meal. Sardinian Cannonau wine, made from Grenache grapes, specifically has significantly more healthy flavonoids than other wines. Tea is also sipped daily throughout the Blue Zone regions, but beverages like soft drinks are practically unknown.
7. Faith: The vast majority of Blue Zone people belong to a faith-based community and attend faith-based services regularly.
8. Family: Centenarians put family first and are all about keeping the family close. They commit to a life partner and take time to build memories with their children. 
9. Social networks: Friendship and close social circles support healthy behaviors in the Blue Zone regions. Okinawans in particular have created something called moais, which are groups of five friends that are committed to each other for life.

What is the ‘Blue Zone’ diet and how does it work?

Research suggests that a strong mechanism behind the longevity and reduction of chronic disease in Blue Zone people is the anti-inflammatory benefits of their dietary choices. While these centenarians aren’t necessarily completely vegan, their diets do have a predominant focus on plants.

How to Start a Mediterranean Diet

Vegetables, especially homegrown, are a huge emphasis for Blue Zone people and provide a ton of vitamins, minerals, fiber, and antioxidant benefits. Beans and lentils are strong plant-based sources of protein in these populations. Similarly to vegetables, legumes also provide a ton of fiber which has benefits ranging from reducing risk of cardiovascular disease to helping control blood sugar levels. Healthy fats, such as olive oil, are used in several of the Blue Zone regions and provide a slew of heart-healthy fatty acids and antioxidants.

Blue zone people limit their consumption of red meat, and even only enjoy small portions of fish about three times per week. These populations do still indulge in moderation regarding sweets and other foods, but they eat sensibly and don’t overindulge. By maintaining moderation and balance with food choices, especially following rules such as the Okinawans do with the hara hachi bu principle, weight stays controlled and obesity is not as prevalent to fuel chronic disease.

Blue Zone diet food list:

Based on the “Power 9” principle of plant slant that the Blue Zone regions embrace, we’ve put together a food list that can help you get started on eating the Blue Zone way.

Produce

• Fruit: apples, bananas, berries, grapes, oranges, papaya, pineapple, plums, watermelon, etc
• Vegetables: bell peppers, beets, broccoli, carrots, cauliflower, chard, collard greens, cucumber, garlic, green beans, kale, onions, potatoes, spinach, tomatoes, etc.

Protein

• Beans & legumes: black beans, chickpeas, kidney beans, lentils, etc.
• Eggs (up to two to four times per week)
• Fish (up to three small servings a week): anchovies, salmon, cod, swordfish, tuna, sardines, etc.
• Goat milk and goat-based dairy products
• Nuts: almonds, Brazil nuts, cashews, peanuts, walnuts, etc.
• Seeds: pumpkin seeds, chia seeds, flax seeds, hemp seeds, etc.
• Tofu, extra-firm

Grains & Pantry Staples

• Barley
• Brown Rice
• Coffee
• Dried spices and fresh herbs
• Oatmeal, preferably steel-cut
• Olive oil
• Quinoa
• Red wine
• Tea
• 100% Whole wheat, sprouted grain bread, and sourdough bread

What is a COVID-19 PCR test?

The polymerase chain reaction (PCR) test for COVID-19 is a molecular test that analyzes your upper respiratory specimen, looking for genetic material (ribonucleic acid or RNA) of SARS-CoV-2, the virus that causes COVID-19. Scientists use the PCR technology to amplify small amounts of RNA from specimens into deoxyribonucleic acid (DNA), which is replicated until SARS-CoV-2 is detectable if present. The PCR test has been the gold standard test for diagnosing COVID-19 since authorized for use in February 2020. It’s accurate and reliable.

Who should get tested for COVID-19?

Your healthcare provider may recommend testing for COVID-19 if you have any of the following symptoms:

• Fever or chills.
• Cough.
• Shortness of breath or difficulty breathing.
• Fatigue.
• Muscle or body aches.
• Headache.
• New loss of taste or smell.
• Sore throat.
• Congestion or runny nose.
• Nausea or vomiting.
• Diarrhea.

Not everyone with COVID-19 develops symptoms. And not all symptomatic people develop all of the symptoms listed above. Please check with your healthcare provider if you’re feeling unwell during the COVID-19 pandemic — even if you’ve been vaccinated.

TEST DETAILS

There are three key steps to the COVID-19 PCR test:

1. Sample collection: A healthcare provider uses a swab to collect respiratory material found in your nose. A swab is a soft tip on a long, flexible stick that goes into your nose. There are different types of nose swabs, including nasal swabs that collect a sample immediately inside your nostrils and nasopharyngeal swabs that go further into the nasal cavity for collection. Either type of swab is sufficient for collecting material for the COVID-19 PCR test. After collection, the swab is sealed in a tube and then sent to a laboratory.
2. Extraction: When a laboratory scientist receives the sample, they isolate (extract) genetic material from the rest of the material in the sample.
3. PCR: The PCR step then uses special chemicals and enzymes and a PCR machine called a thermal cycler. Each heating and cooling cycle increases (amplifies) the amount of the targeted genetic material in the test tube. After many cycles, millions of copies of a small portion of the SARS-CoV-2 virus’s genetic material are present in the test tube. One of the chemicals in the tube produces a fluorescent light if SARS-CoV-2 is present in the sample. Once amplified enough, the PCR machine can detect this signal. Scientists use special software to interpret the signal as a positive test result.

RESULTS AND FOLLOW-UP

What do COVID-19 PCR test results mean?

A positive test result means that it’s likely that you have an infection with SARS-CoV-2. This could be due to asymptomatic infection, but if you have symptoms, then this infection is called COVID-19. Most people have mild illness and can recover safely at home without medical care. Contact your healthcare provider if your symptoms get worse or if you have questions or concerns.

A negative test result means you probably didn’t have an infection with SARS-CoV-2 at the time your specimen was collected. However, it’s possible to have COVID-19 but not have the virus detected by the test. For example, this may happen if you recently became infected but you don’t have symptoms yet — or it could happen if you’ve had COVID-19 for more than a week before being tested. A negative test doesn’t mean you are safe for any length of time: You can be exposed to COVID-19 after your test, get infected and spread the SARS-Cov-2 virus to others.

If your test is positive, talk with your healthcare provider, stay home and separate yourself from others. If your test is negative, continue to take steps to protect yourself and others from getting COVID-19.

How long does it take to get coronavirus test results?

You should receive your test results as early as 24 hours after sample collection, but sometimes it can take a few days, depending on how long it takes the sample to reach the laboratory.

How long do you test positive after having had COVID-19?

Because the PCR test is so sensitive, it can detect very small amounts of virus material. This means that the test can continue to detect fragments of SARS-CoV-2 virus even after you’ve recovered from COVID-19 and are no longer contagious. So you may continue to test positive if you’ve had COVID-19 in the distant past, even though you can’t spread the SARS-CoV-2 virus to others.

Prolonged infection in immunocompromised individuals can occur where they shed infectious virus for months. Also, healthy people can become reinfected. If you test positive for SARS-CoV-2 but you think you might have already recovered from COVID-19, please discuss with a healthcare provider.

ADDITIONAL DETAILS

What’s the difference between the PCR and antigen tests for COVID-19?

There are two types of tests for COVID-19: the PCR test and the antigen test.

• Polymerase chain reaction (PCR). This tests for the presence of the actual virus’s genetic material or its fragments as it breaks down. PCR is the most reliable and accurate test for detecting active infection. PCR tests typically take hours to perform, but some are faster.
• Antigen test: This detects bits of proteins on the surface of the virus called antigens. Antigen tests typically take only 15 to 30 minutes. Rapid antigen tests are most accurate when used within a few days of the start of your symptoms, which is when the largest amount of virus is present in your body.

Which COVID test is more accurate?

The antigen test is typically faster but is less sensitive than the PCR test. Because the antigen test is not as accurate as PCR, if an antigen test is negative, your healthcare provider could request a PCR test to confirm the negative antigen test result.