Blue zone: Difference between revisions

Content deleted Content added

Inline

Revision as of 23:19, 17 May 2024

A Blue zone is a places in the world which has a high concentration of centenarians in addition to clusters of people who have lived beyond the age of 60-years without disease and/or other health conditions such as obesity, cancer, diabetes, and heart problems.^[1] Examples of blue zones are listed below. The name "blue zones" derived simply during the original survey by demographers, who "used a blue pen on a map to mark the villages with long-lived population."^[1]

Initial analysis was that the apparent longevity of blue zone populations resulted from practice of a traditional lifestyle involving intense physical activity beyond the age of 80-yers in predominantly rural areas, with low levels of stress, excellent family and community support, who consume locally produced, seasonal, fresh foods. It was postulated that the remarkably good health status during ageing could be the result of a delicate balance between the benefits of a traditional lifestyle with those of modernity (increased wealth and better medical care).^[1]

The concept of blue zones having exceptional longevity has been challenged by the absence of the scientific method being used to produce evidence-based information^[2] and by the substantial decline of life expectancy during the 21st century in one of the blue zones, Okinawa.^[3]

History

The epidemiological study "AKEntAnnos. The Sardinia Study of Extreme Longevity" (AKEntAnnos is a Sardinian phrase which means approximatively “Health & life up to 100”) of centenarians living in a large island in the Mediterranean sea ^[4] was enhanced by the experimental gerontological study in Sardinia which led to the introduction of the concept of the "Blue Zone" by Michel Poulain with Gianni Pes, Luca Deiana and other colleagues in terms of locations with populations experiencing rates of above-average longevity funded by the US National Institute on Aging (Duke University) the MaxPlanck Institute for Demographic Research (MPIDR) the government of Sardinia.^[5] ^[1] This seminal work that developed the concept of blue zones grabbed global attention when first presented at the International Union for the Scientific Study of the Population conference in 2000 where a short paper by Poulain was presented about the validation of exceptional male longevity in Sardinia and then again with the full article on the Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study (AKEA being an acronym for AKEntAnnos) in the journal of Experimental Gerontology in 2004.^[5] The work identified Sardinia's Nuoro province as the region with the highest concentration of male centenarians, referring to the area as the "blue zone" (a term chosen simply because the authors happened to use blue ink to mark a map of the regions with many centenarians).^[1]^[5]

Zones

Sardinia

Nicoya

Icaria

Loma Linda

Okinawa

class=notpageimage|

Proposed blue zones

The proposed blue zones identified by Michel Poulain and colleagues include:

Nuoro Province, Sardinia, Italy ^[5]
Okinawa Prefecture, Japan ^[6]
Nicoya Peninsula, Costa Rica ^[1]
Icaria, Greece ^[1]
Martinique, France ^[7]

Estimating population longevity

In the original study of centenarians living in 14 mountain villages of Sardinia (the first proposed blue zone), the research team developed an Extreme Longevity Index (ELI) representing the ratio between the number of eventual centenarians born between 1880 and 1900, and the total number of births recorded during the same time interval for the region.^[1] The ELI was defined as the number of centenarians per 10,000 newborns, and was equated to the probability for any person born in that municipality to reach 100 years old and remain functional.^[1]

During the period of births between 1880 and 1900 in the Sardinia blue zone, 47 men and 44 women eventually reached age 100, giving an average ELI value per 100,000 births of 508 for the blue zone location, whereas the rest of Sardinia had ELI values 2–4 times lower (less longevity).^[1]

Another longevity index applied was the Centenarian rate (CR) for the 1900 birth group (number of persons surviving to 100 years old per 10,000 people alive at age 60) in December 2000.^[1] The Sardinia and Okinawa blue zones had CR values for men substantially higher compared to several other countries, whereas values for women were mostly above those in other countries, while comparable to others.^[1]

Several possible errors or limitations exist for these estimates, such as unreliability or absence of birth records.^[1]

Life expectancy in blue zones is proposed to be as much as a decade or longer, compared to the average world life expectancy of 73 years in 2019.^[8]^[9]^{[medical citation needed]}

Seven principles

As summarised by Michel Poulain^[10]:

Move naturally, without excess but with endurance
Eat wisely, without surfeit and locally available seasonal fresh foods
Avoid stress and sleep well following the diurnal cycle of the sun, going to sleep at sunset and waking at sunrise
Maintain strong family ties, sharing lives with children/grandchildren and enjoying frequent celebrations together
Strong social networks & community support, where elders are valued for their continuing contributions to the community
Deep traditions that include respect for nature and community
Life purpose based in spiritual beliefs

Marketing

Loma Linda, California, United States, was also identified as a blue zone by author Dan Buettner, founder of the marketing company, Blue Zones LLC, and popular press, which described the Seventh-Day Adventist community there as having unusual longevity due putatively to a healthy lifestyle and plant-based diet.^[8]^[9] In 2020, Blue Zones LLC was acquired by the Seventh-Day Adventist health care system, Adventist Health.^[11]

Scientific reception

A study of claimed longevity in Okinawa was unable to verify whether residents were as old as they reported due to many records not surviving World War II.^[12] When analyzed in the 21st century, life expectancy in Okinawa was deemed to no longer be exceptional when compared to the rest of Japan, as "male longevity is now ranked 26th among the 47 prefectures of Japan."^[3]

Harriet Hall, writing for Science-Based Medicine, stated that there are no controlled studies of elderly people in the blue zones, and that blue zone diets are based on speculation, not evidence through a rigorous scientific method.^[2]

References

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m Poulain, Michel; Herm, Anne; Pes, Gianni. The Blue Zones: areas of exceptional longevity around the world in: Vienna Yearbook of Population Research, vol. 11, 2013, p. 87–108. backup Quote: "...These populations succeeded in maintaining a traditional lifestyle implying an intense physical activity that extends beyond the age of 80, a reduced level of stress and intensive family and community support for their oldest olds as well as the consumption of locally produced food...Based on a strict validation method, the ages of Sardinian centenarians were thoroughly proven to be correct (Poulain et al. 2006)... [footnote 2:] The term was chosen simply because at the time the authors used a blue pen on a map to mark the villages with long-lived population... [definition:] In practice, a blue zone (BZ) is defined as a rather limited and homogenous geographical area where the population shares the same lifestyle and environment and its longevity has been proved to be exceptionally high. [] Other validated BZs have been found so far in Okinawa (Japan), on the Nicoya peninsula (Costa Rica) and on the island of Ikaria (Greece)...The extreme longevity area identified in Sardinia and named as Blue Zone (BZ) includes a group of 14 villages in Barbagia and Ogliastra, covering the highest mountain area of Sardinia.4...Starting from 2005, in cooperation with D. Buettner, a journalist writing for National Geographic, the BZ concept was extended to other relevant regions of the earth (Buettner 2012). Exceptional longevity at population level has been identified and validated so far in three other settings: the island of Okinawa in Japan, the peninsula of Nicoya in Costa Rica and the island of Ikaria in Greece (Figures 3)..."
^ ^a ^b Hall, Harriet. (2021). "Blue Zones Diet: Speculation Based on Misinformation". Science-Based Medicine. Retrieved 15 October 2021.
^ ^a ^b Hokama, Tomiko; Binns, Colin (October 2008). "Declining longevity advantage and low birthweight in Okinawa". Asia-Pacific Journal of Public Health. 20 Suppl: 95–101. PMID 19533867.
^ Deiana L, Ferrucci L, Pes GM, Carru C, Delitala G, Ganau A, Mariotti S, Nieddu A, Pettinato S, Putzu P, Franceschi C, Baggio G. AKEntAnnos. The Sardinia Study of Extreme Longevity. Aging (Milano). 1999 Jun;11(3):142-9. https://pubmed.ncbi.nlm.nih.gov/10476308/
^ ^a ^b ^c ^d Michel Poulain, Giovanni Mario Pes, Claude Grasland, Ciriaco Carru, Luigi Ferrucci, et al.. Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Experimental Gerontology, 2004, 39 (9), pp.1423-1429. https://shs.hal.science/halshs-00175541/file/2004%20POULAIN%20BZ%20EXP%20GERONT.pdf
^ Poulain, M., Naito, K. (2004). L’évolution de la longévité à Okinawa, 1921-2000 (2004). Cahiers québécois de démographie, 33,1 29–49 https://doi.org/10.7202/010851ar
^ Poulain & Herme (2023) Validation of exceptional longevity in Martinique. https://longevitybluezone.com/wp-content/uploads/2023/03/validation-martinique-26-mars-eng.pdf
^ ^a ^b Alexa Mikhail (2 April 2023). "A look inside America's only blue zone city—home to some of the world's longest-living people". Fortune. Retrieved 2 January 2024.
^ ^a ^b Marcia Wendorf (10 February 2022). "People routinely live over 100 years in global "blue zones". Should you move?". Interesting Engineering. Retrieved 4 January 2024.
^ https://longevitybluezone.com/
^ "Adventist Health acquires Blue Zones as part of transformation into catalyst for overall community health and wellbeing". Adventist Health. 8 April 2020. Archived from the original on 7 March 2023. Retrieved 2 January 2024.
^ Poulain, Michel (2011-07-21). "Exceptional Longevity in Okinawa:: A Plea for In-depth Validation". Demographic Research. 25 (7): 245–284. doi:10.4054/DemRes.2011.25.7.

@@ Line 1: / Line 1: @@
 {{Short description|Regions of the world where people are claimed to live longer than average}}
 {{About||the band|Blue Zone (band)|the parking zone regulations|Disc parking|parts of the United States which vote majority Democrat|Red states and blue states}}
-'''Blue zones''' are regions in the world where people are claimed to live longer [[Life expectancy|than average]].<ref name="Poulain">Poulain, Michel; Herm,&nbsp;Anne; Pes,&nbsp;Gianni.&nbsp;[http://austriaca.at/0xc1aa500e_0x00307bb6.pdf The Blue Zones: areas of exceptional longevity around the world] in:&nbsp;Vienna Yearbook of Population Research, vol. 11, 2013, p.&nbsp;87–108. [https://web.archive.org/web/20200302043123/http://austriaca.at/0xc1aa500e_0x00307bb6.pdf backup] Quote: "...These populations succeeded in maintaining a traditional lifestyle implying an intense physical activity that extends beyond the age of 80, a reduced level of stress and intensive family and community support for their oldest olds as well as the consumption of locally produced food...Based on a strict validation method, the ages of Sardinian centenarians were thoroughly proven to be correct (Poulain et al. 2006)... [footnote 2:] The term was chosen simply because at the time the authors used a blue pen on a map to mark the villages with long-lived population... [definition:] In practice, a blue zone (BZ) is defined as a rather limited and homogenous geographical area where the population shares the same lifestyle and environment and its longevity has been proved to be exceptionally high. [] Other validated BZs have been found so far in Okinawa (Japan), on the Nicoya peninsula (Costa Rica) and on the island of Ikaria (Greece)...The extreme longevity area identified in Sardinia and named as Blue Zone (BZ) includes a group of 14 villages in Barbagia and Ogliastra, covering the highest mountain area of Sardinia.4...Starting from 2005, in cooperation with D. Buettner, a journalist writing for National Geographic, the BZ concept was extended to other relevant regions of the earth (Buettner 2012). Exceptional longevity at population level has been identified and validated so far in three other settings: the island of Okinawa in Japan, the peninsula of Nicoya in Costa Rica and the island of Ikaria in Greece (Figures 3)..."</ref> Examples of blue zones include [[Okinawa Prefecture]], Japan; [[Province of Nuoro|Nuoro Province]], Sardinia, Italy; the [[Nicoya Peninsula]], Costa Rica; and [[Icaria]], Greece.<ref name="Poulain" /> The name "blue zones" derived simply during the original survey by scientists, who "used a blue pen on a map to mark the villages with long-lived population."<ref name=Poulain/>
+A '''Blue zone''' is a places in the world which has a high concentration of [[Centenarian|centenarians]] in addition to clusters of people who have lived beyond the age of 60-years without disease and/or other health conditions such as obesity, cancer, diabetes, and heart problems.<ref name="Poulain">Poulain, Michel; Herm,&nbsp;Anne; Pes,&nbsp;Gianni.&nbsp;[http://austriaca.at/0xc1aa500e_0x00307bb6.pdf The Blue Zones: areas of exceptional longevity around the world] in:&nbsp;Vienna Yearbook of Population Research, vol. 11, 2013, p.&nbsp;87–108. [https://web.archive.org/web/20200302043123/http://austriaca.at/0xc1aa500e_0x00307bb6.pdf backup] Quote: "...These populations succeeded in maintaining a traditional lifestyle implying an intense physical activity that extends beyond the age of 80, a reduced level of stress and intensive family and community support for their oldest olds as well as the consumption of locally produced food...Based on a strict validation method, the ages of Sardinian centenarians were thoroughly proven to be correct (Poulain et al. 2006)... [footnote 2:] The term was chosen simply because at the time the authors used a blue pen on a map to mark the villages with long-lived population... [definition:] In practice, a blue zone (BZ) is defined as a rather limited and homogenous geographical area where the population shares the same lifestyle and environment and its longevity has been proved to be exceptionally high. [] Other validated BZs have been found so far in Okinawa (Japan), on the Nicoya peninsula (Costa Rica) and on the island of Ikaria (Greece)...The extreme longevity area identified in Sardinia and named as Blue Zone (BZ) includes a group of 14 villages in Barbagia and Ogliastra, covering the highest mountain area of Sardinia.4...Starting from 2005, in cooperation with D. Buettner, a journalist writing for National Geographic, the BZ concept was extended to other relevant regions of the earth (Buettner 2012). Exceptional longevity at population level has been identified and validated so far in three other settings: the island of Okinawa in Japan, the peninsula of Nicoya in Costa Rica and the island of Ikaria in Greece (Figures 3)..."</ref> Examples of blue zones are listed below. The name "blue zones" derived simply during the original survey by demographers, who "used a blue pen on a map to mark the villages with long-lived population."<ref name=Poulain/>
+Initial analysis was that the apparent longevity of blue zone populations resulted from practice of a traditional lifestyle involving intense physical activity beyond the age of 80-yers in predominantly rural areas, with low levels of stress, excellent family and community support, who consume locally produced, seasonal, fresh foods. It was postulated that the remarkably good health status during ageing could be the result of a delicate balance between the benefits of a traditional lifestyle with those of modernity (increased wealth and better medical care).<ref name="Poulain" />
-The concept of blue zones having exceptional longevity has been challenged by the absence of scientific proof,<ref name=hall/> and by the substantial decline of life expectancy during the 21st century in an original proposed blue zone, Okinawa.<ref name=hokama/>
+The concept of blue zones having exceptional longevity has been challenged by the absence of the scientific method being used to produce evidence-based information<ref name="hall" /> and by the substantial decline of life expectancy during the 21st century in one of the blue zones, Okinawa.<ref name="hokama" />
 ==History==
 [[File:Old Sardinian Man.jpg|thumbnail|right|An elderly [[Sardinians|Sardinian]] man]]
-The concept of blue zones resulted from [[Demography|demographic]] work published by [[Michel Poulain]] and colleagues in 2004.<ref name="poulain-2004">{{Cite journal|display-authors=3|last1=Poulain|first1=Michel|last2=Pes|first2=Giovanni Mario|last3=Grasland|first3=Claude|last4=Carru|first4=Ciriaco|last5=Ferrucci|first5=Luigi|last6=Baggio|first6=Giovannella|last7=Franceschi|first7=Claudio|last8=Deiana|first8=Luca|date=2004-09-01|title=Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study|journal=[[Experimental Gerontology]]|volume=39|issue=9|pages=1423–1429|doi=10.1016/j.exger.2004.06.016|pmid=15489066|s2cid=21362479|url=https://halshs.archives-ouvertes.fr/halshs-00175541/file/2004%20POULAIN%20BZ%20EXP%20GERONT.pdf|access-date=2019-09-17|archive-url=https://web.archive.org/web/20200107022251/https://halshs.archives-ouvertes.fr/halshs-00175541/file/2004%20POULAIN%20BZ%20EXP%20GERONT.pdf|archive-date=2020-01-07|url-status=live}}</ref> They identified [[Sardinia]]'s [[Nuoro province]] as the region with the highest concentration of male [[centenarian]]s, referring to the area as the "blue zone" (a term chosen because the authors used a blue pen to mark a map of the villages with many centenarians).<ref name="Poulain"/><ref name="poulain-2004"/>
+The epidemiological study "[https://pubmed.ncbi.nlm.nih.gov/10476308/ AKEntAnnos. The Sardinia Study of Extreme Longevity]" (AKEntAnnos is a Sardinian phrase which means approximatively “Health & life up to 100”) of centenarians living in a large island in the Mediterranean sea <ref>Deiana L, Ferrucci L, Pes GM, Carru C, Delitala G, Ganau A, Mariotti S, Nieddu A, Pettinato S, Putzu P, Franceschi C, Baggio G. AKEntAnnos. The Sardinia Study of Extreme Longevity. Aging (Milano). 1999 Jun;11(3):142-9. https://pubmed.ncbi.nlm.nih.gov/10476308/</ref> was enhanced by the experimental gerontological study in [[Sardinia]] which led to the introduction of the concept of the "[[Blue Zone]]" by [[Michel Poulain]] with Gianni Pes, Luca Deiana and other colleagues in terms of locations with populations experiencing rates of above-average longevity funded by the US National Institute on Aging (Duke University) the MaxPlanck Institute for Demographic Research (MPIDR) the government of Sardinia.<ref name=":0">Michel Poulain, Giovanni Mario Pes, Claude Grasland, Ciriaco Carru, Luigi Ferrucci, et al.. Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA
-Initial analysis was that the apparent longevity of blue zone populations resulted from practice of a traditional lifestyle, including regular physical activity beyond age 80, providing family and community support for elders, and consuming locally produced food.<ref name=Poulain/>
+study. Experimental Gerontology, 2004, 39 (9), pp.1423-1429. https://shs.hal.science/halshs-00175541/file/2004%20POULAIN%20BZ%20EXP%20GERONT.pdf</ref> <ref name="Poulain" /> This seminal work that developed the concept of blue zones grabbed global attention when first presented at the International Union for the Scientific Study of the Population conference in 2000 where a short paper by Poulain was presented about the [https://link.springer.com/content/pdf/10.1007/978-1-4020-4848-7_7 validation of exceptional male longevity in Sardinia] and then again with the full article on the [https://www.sciencedirect.com/science/article/abs/pii/S0531556504002141 Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study] (AKEA being an acronym for AKEntAnnos) in the journal of Experimental Gerontology in 2004.<ref name=":0" /> The work identified [[Sardinia]]'s [[Nuoro province]] as the region with the highest concentration of male [[centenarian]]s, referring to the area as the "blue zone" (a term chosen simply because the authors happened to use blue ink to mark a map of the regions with many centenarians).<ref name="Poulain" /><ref name=":0" />
 == Zones ==
@@ Line 70: / Line 72: @@
 }}
+The proposed blue zones identified by [[Michel Poulain]] and colleagues include:
-Proposed blue zones include:{{reliable|date=May 2024}}
-*[[Province of Nuoro|Nuoro Province]], Sardinia, Italy
+*[[Province of Nuoro|Nuoro Province]], Sardinia, Italy <ref name=":0" />
+*[[Okinawa Prefecture]], Japan <ref>Poulain, M., Naito, K. (2004). L’évolution de la longévité à Okinawa, 1921-2000 (2004). Cahiers québécois de démographie, 33,1 29–49 https://doi.org/10.7202/010851ar</ref>
-*[[Okinawa Prefecture]], Japan
-*[[Nicoya Peninsula]], Costa Rica
+*[[Nicoya Peninsula]], Costa Rica <ref name="Poulain" />
-*[[Icaria]], Greece
+*[[Icaria]], Greece <ref name="Poulain" />
+*[[Martinique]], France <ref>Poulain & Herme (2023) Validation of exceptional longevity in Martinique. https://longevitybluezone.com/wp-content/uploads/2023/03/validation-martinique-26-mars-eng.pdf</ref>
 ===Estimating population longevity===
@@ Line 86: / Line 89: @@
 [[Life expectancy]] in blue zones is proposed to be as much as a decade or longer, compared to the average world life expectancy of 73 years in 2019.<ref name="mikhail">{{cite web |author1=Alexa Mikhail |title=A look inside America's only blue zone city—home to some of the world's longest-living people |url=https://fortune.com/well/2023/04/02/longevity-tips-loma-linda-california-blue-zone-city/ |publisher=Fortune |access-date=2 January 2024 |date=2 April 2023}}</ref><ref name="ie">{{cite web |author1=Marcia Wendorf |title=People routinely live over 100 years in global "blue zones". Should you move? |url=https://interestingengineering.com/health/people-routinely-live-beyond-the-age-of-100-in-these-rare-blue-zones |publisher=Interesting Engineering |access-date=4 January 2024 |date=10 February 2022}}</ref>{{medcn|date=January 2024}}
+=== Seven principles ===
+As summarised by Michel Poulain<ref>https://longevitybluezone.com/</ref>:
+#Move naturally, without excess but with endurance
+#Eat wisely, without [[Overeating|surfeit]] and locally available seasonal fresh foods
+#Avoid stress and sleep well following the [[diurnal cycle]] of the sun, going to sleep at sunset and waking at sunrise
+#Maintain strong family ties, sharing lives with children/grandchildren and enjoying frequent celebrations together
+#Strong social networks & community support, where elders are valued for their continuing contributions to the community
+#Deep traditions that include respect for nature and community
+#Life purpose based in spiritual beliefs
 ===Marketing===
-[[Loma Linda, California|Loma Linda]], California, United States, was included as a blue zone by [[Dan Buettner]], founder of the marketing company, Blue Zones LLC, and popular press, which described the [[Seventh-Day Adventist]] community there as having unusual longevity due putatively to a healthy lifestyle and [[plant-based diet]].<ref name=mikhail/><ref name=ie/> In 2020, Blue Zones LLC was acquired by the Seventh-Day Adventist health care system, [[Adventist Health]].<ref>{{cite web |date=8 April 2020 |title=Adventist Health acquires Blue Zones as part of transformation into catalyst for overall community health and wellbeing |url=https://www.adventisthealth.org/blog/2020/april/adventist-health-acquires-blue-zones-as-part-of-/ |url-status=dead |archive-url=https://web.archive.org/web/20230307081809/https://www.adventisthealth.org/blog/2020/april/adventist-health-acquires-blue-zones-as-part-of-/ |archive-date=7 March 2023 |accessdate=2 January 2024 |publisher=Adventist Health}}</ref>
+[[Loma Linda, California|Loma Linda]], California, United States, was also identified as a blue zone by author  [[Dan Buettner]], founder of the marketing company, Blue Zones LLC, and popular press, which described the [[Seventh-Day Adventist]] community there as having unusual longevity due putatively to a healthy lifestyle and [[plant-based diet]].<ref name=mikhail/><ref name=ie/> In 2020, Blue Zones LLC was acquired by the Seventh-Day Adventist health care system, [[Adventist Health]].<ref>{{cite web |date=8 April 2020 |title=Adventist Health acquires Blue Zones as part of transformation into catalyst for overall community health and wellbeing |url=https://www.adventisthealth.org/blog/2020/april/adventist-health-acquires-blue-zones-as-part-of-/ |url-status=dead |archive-url=https://web.archive.org/web/20230307081809/https://www.adventisthealth.org/blog/2020/april/adventist-health-acquires-blue-zones-as-part-of-/ |archive-date=7 March 2023 |accessdate=2 January 2024 |publisher=Adventist Health}}</ref>
 ==Scientific reception==
 A study of claimed longevity in Okinawa was unable to verify whether residents were as old as they reported due to many records not surviving [[World War II]].<ref>{{Cite journal|last=Poulain |first=Michel |url=https://www.researchgate.net/publication/227409038 |title=Exceptional Longevity in Okinawa:: A Plea for In-depth Validation |date=2011-07-21 |journal=[[Demographic Research (journal)|Demographic Research]] |volume=25 |issue=7 |pages=245–284 |doi=10.4054/DemRes.2011.25.7|doi-access=free }}</ref> When analyzed in the 21st century, life expectancy in Okinawa was deemed to no longer be exceptional when compared to the rest of Japan, as "male longevity is now ranked 26th among the 47 [[Prefectures_of_Japan |prefectures]] of Japan."<ref name="hokama">{{Cite journal |last1=Hokama |first1=Tomiko |title=Declining longevity advantage and low birthweight in Okinawa |url=https://www.researchgate.net/publication/26299015 |journal=[[Asia-Pacific Journal of Public Health]] |volume=20 Suppl |pages=95–101 |date=October 2008 |pmid=19533867 |last2=Binns |first2=Colin |author-link2=Colin Binns}}</ref>
-[[Harriet Hall]], writing for ''[[Science-Based Medicine]]'', stated that there are no controlled studies of elderly people in the blue zones, and that blue zone diets are based on speculation, not solid science.<ref name="hall">Hall, Harriet. (2021). [https://sciencebasedmedicine.org/blue-zones-diet-speculation-based-on-misinformation/ "Blue Zones Diet: Speculation Based on Misinformation"]. Science-Based Medicine. Retrieved 15 October 2021.</ref>
+[[Harriet Hall]], writing for ''[[Science-Based Medicine]]'', stated that there are no controlled studies of elderly people in the blue zones, and that blue zone diets are based on speculation, not evidence through a rigorous scientific method.<ref name="hall">Hall, Harriet. (2021). [https://sciencebasedmedicine.org/blue-zones-diet-speculation-based-on-misinformation/ "Blue Zones Diet: Speculation Based on Misinformation"]. Science-Based Medicine. Retrieved 15 October 2021.</ref>
 ==See also==
@@ Line 109: / Line 124: @@
 ==Further reading==
 * {{cite web |title=Eating To Break 100: Longevity Diet Tips From The Blue Zones |date=11 April 2015 |accessdate=28 Jan 2022 |author=Eliza Barclay |website=NPR: The Salt |url=https://www.npr.org/sections/thesalt/2015/04/11/398325030/eating-to-break-100-longevity-diet-tips-from-the-blue-zones}}
+* A long list of other articles for further reading can also be found at https://longevitybluezone.com/scientific-research/
 {{Longevity}}