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Diets Debunked: The Blue Zones™ Diet

Written by Dr. Michael Ruscio, DC on April 15, 2025

Written by Dr. Michael Ruscio, DC on April 15, 2025 — Reviewed by Hilary Watts

• What Are Blue Zones?|
• Blue Zones™ Principles|
• What’s on the Menu?|
• Good Points|
• Drawbacks|
• Gut Clinician’s Perspective|
• Comparisons|

Diet trends come and go faster than you can say spirulina smoothie, but some stick around because they claim to offer more than just a quick fix—they promise a longer life. 

Enter the Blue Zones™ diet, an eating and lifestyle plan inspired by the world’s so-called “longevity hotspots.”

The claims made are bold: Live longer and healthier, sidestepping chronic disease. The main focus is on maintaining health and vigor well into old age, though advocates claim weight loss is often a benefit. It’s pitched as a universal fit—flexible enough for anyone to work into their life.

So, does the Blue Zones™ diet live up to the hype, or should you give it a swerve? Spoiler alert: There’s some wisdom here, but it’s not rock-solid science.

This article is part of our Diets Debunked series—designed to give you a skeptical yet helpful take on popular diets. If you’re curious about Weight Watchers, the E2M diet, or Noom, we’ve got those covered too. But for now, let’s dive into what blue zones are all about.

What Are Blue Zones?

“Blue zones” are regions around the world with high numbers of healthy centenarians—people living past 100 who avoid common chronic diseases like heart disease, cancer, diabetes, and dementia 1. The five most widely recognized blue zones are:

• Okinawa (Japan)
• Sardinia (Italy)
• Nicoya Peninsula (Costa Rica)
• Ikaria (Greece)
• Loma Linda (California)

The blue zones concept emerged in the early 2000s when researchers Giovanni Pes and Michel Poulain identified Sardinia, an island off the coast of Italy, as a longevity hotspot 2. Around the same time, Dan Buettner—a National Geographic explorer and journalist—became fascinated by the long-lived residents of Okinawa, Japan. 

What followed was a collaboration between Buettner, Pes, and Poulain to identify more blue zones. Buettner later trademarked Blue Zones® 3 and turned the Blue Zones™ principles of diet and lifestyle into a commercial venture.

However, the original team eventually split due to disagreements. As a result, there are now two blue zones sources: one owned by Blue Zones, LLC, shaped by Buettner’s views, and another managed by Poulain. Because the Blue Zones™ diet trend is marketed by Buettner and shaped by his work, in this article, we are focusing on Buettner’s version of the Blue Zones™ diet.

A point of interest: Poulain never considered Loma Linda a true blue zone, viewing it as a religious (Seventh-day Adventist) community instead. He’s also added the Caribbean island of Martinique to his list.

It’s also worth noting that the validity of blue zones as a whole has been questioned, largely due to historical inaccuracies in birth and death records. Especially in low-income areas with poor literacy rates, it’s hard to be accurate about how long people really live 4 5.

Overall, we don’t know for sure whether blue zones are a real phenomenon or not. But we can examine the lifestyle habits promoted by the Blue Zones™ brand, assess their scientific validity, and judge them by the evidence.

Blue Zones™ Core Principles

Embracing the Blue Zones™ diet and lifestyle plan means following these nine longevity habits (the Power 9®), which are split between four core categories 3:

Move

• Move naturally: Engage in regular daily activities rather than structured exercise like marathons or gym workouts.

Right outlook

• Purpose: Have a clear sense of purpose in life.
• Downshift: Reduce and manage stress through relaxation and mindfulness.

Eat wisely

• 80% rule: Stop eating when you’re 80% full to maintain a healthy weight.
• Plant slant: Eat mostly plant-based foods, with a focus on lentils and legumes.
• Wine at 5: Drink a couple of small glasses of wine daily with friends and food.

Connect

• Right tribe: Surround yourself with a supportive social circle that encourages healthy behaviors.
• Loved ones first: Prioritize family by keeping aging relatives close, committing to a life partner, and spending quality time with children.
• Belong: Engage with a faith-based or community group for a sense of belonging.

Let’s zoom in on the eating wisely section to see what you actually eat on a Blue Zones™ diet.

What’s on the Menu?

The Blue Zones™ diet is unprocessed and 95% plant-based—think a plate loaded with veggies, legumes, whole grains, nuts, and fruits. Meat makes only a rare appearance, and dairy is largely off the menu, aside from the occasional sip of goat’s or sheep’s milk, or a fermented product like yogurt or kefir 6.

Similarly, eggs are limited, and sugar in food is capped at 7 teaspoons a day 6.

On the other hand, a glass or two of red wine with friends gets the green light, and you can drink as much coffee or tea as you like. That said, water is the top choice—ideally, around seven glasses a day 6.

Importantly, you rarely, if ever, overeat. Instead, you get up from the table when you are 80% full.

What’s Good About the Blue Zones™ Diet?

For context, it’s important to know that the Blue Zones™ diet relies largely on anecdotal evidence—observations of what people in blue zones eat—to support its dietary principles. This leaves more room for doubt than a properly controlled clinical trial would, but that doesn’t mean the data isn’t still meaningful.

In fact, many widely accepted dietary recommendations are based solely on observational research—but there’s so much of it that dismissing it entirely wouldn’t make sense.

Here’s where research supports the general nutrition and lifestyle habits promoted by the Blue Zones™ diet:

Eating Largely Plant-Based 

Compared to a Western diet, diets that include lots of veggies, fruits, legumes, whole grains, and a lesser amount of meat are associated with better health and a lower chance of death 7. 

More specifically:

• Legumes: A 50 g (around ¾ cup cooked) daily increase in legumes has been associated with a 6% drop in all-cause death risk 8. 
• Nuts: A daily 28 g serving (large handful) is associated with a 21% cut in heart disease risk and an 11% lower risk of cancer death 9.
• Whole grains: Each daily serving may slash mortality risk by 7%, with big wins against heart disease 10.
• Olive oil: Each 2 teaspoon increase in daily olive oil intake may trim cardiovascular disease death risk by 8%, with the effects plateauing after about 4.5 teaspoons (1.5 tbsp) a day 11.

However, plant-based diets may neglect protein, and this can be a problem, particularly in those who are over-65 7. That’s why I’m not fully on board with the Blue Zones™ dietary principle of limiting meat so strictly—I’ll dive into this more below.

Being Physically Active

A lot of observational and interventional research (where researchers actively measure the effects of an intervention—in this case, exercise) supports the importance of regular physical activity for longevity 12 13 14 15 16. 

But I don’t necessarily agree with the Blue Zones® claim that regular daily activities always trump structured exercise or playing sports. The practicalities of daily life often mean we need to set aside dedicated time for higher-intensity movement. Attending a gym class, going for a run, or cycling with friends can tick the fitness box while fostering social connections.

Cultivating a Sense of Purpose

Observational research suggests that having goals, values, or passions that give life meaning—also known as a sense of purpose—may support healthy aging 17. Cultivating this sense of purpose may involve reflecting on your core values and how to align your life with them. It can also come from helping others, as contributing to something outside yourself is often a powerful source of fulfillment.

Managing Stress

Controlled exposure to healthy stressors encourages resilience and supports healthier aging. Observational research shows that managing chronic stress is linked to better health and increased longevity 17. This includes controlled exposure to hormetic stressors—beneficial stressors like cold exposure, high-intensity exercise, or heat therapy (e.g., saunas) that help the body build resilience. Regular exposure to these mild stressors may encourage adaptability and support healthier aging 18. 

Eating Enough, Not Too Much

From the perspective that it may help regulate calorie intake and support a healthy waistline, the Blue Zones™ dietary recommendation to stop eating before feeling overly full is well-founded. This is a sensible practice that I’d endorse for any diet my clients follow (as long as they aren’t underweight). Maintaining a healthy weight has been shown to be important for promoting a longer, healthier lifespan 19 20.

Building and Maintaining Strong Social Connections 

Observational research shows that strong social relationships are positively correlated with better health and longevity 21. Belonging to a religious or spiritual group has also been associated with living longer 22 23.

Where the Blue Zones™ Diet Falls Down

In general, the Blue Zones™ diet has a lot of good principles, but there are a few areas where it falls short. These are things worth questioning rather than getting hung up on. Let’s dive into some of its less helpful tenets and bust a few myths along the way.

Myth: Limit Eggs to Three a Week

Truth: The Blue Zones™ diet caps eggs at 2–4 per week, citing potential prostate cancer and kidney concerns and that eggs aren’t strictly necessary for living a long life. However, a big meta-analysis (study of studies) found no link between eating more eggs and higher risks of death from heart disease, stroke, or overall causes—though there was a slight uptick in cancer death 24. 

Up to one egg a day seems fine for most, offering protein and valuable nutrients like vitamin D, zinc, and B vitamins. Eggs are also an easy, high-protein start to the day—a favorite protein-rich breakfast for many of my time-pressed clients.

Myth: Only Eat Meat Occasionally

Truth: The Blue Zones™ diet limits meat to just 2 ounces five times a month, but flawed studies and lifestyle factors muddy the waters, meaning the risk of animal proteins is often overblown 25 26 27. High-quality evidence shows that unprocessed red meat 28:

• May slightly raise the total stroke risk but not the risk of death from ischemic stroke or coronary heart disease. 
• Might lower the risk of women dying from hemorrhagic stroke. 

Meat is a solid protein source that also provides more iron and zinc than plant sources. Protein is particularly vital as we age, reducing inflammation 29 and improving physical function in people with low muscle tone 30 31. 

The takeaway? If you’re getting older, your body might thank you for a bit more. Balance it with plants, sure, but no strong evidence says you must steer completely clear 32.

If you do prefer to get your protein from plants, it’s a good idea to work with a registered dietitian or health professional to make sure you are meeting your protein needs.

Myth: Goat’s Milk Wins Over Cow’s Milk

Truth: The Blue Zones™ diet suggests that goat’s milk is superior to cow’s milk and less likely to cause digestive issues. However, with only about 1% less lactose than cow’s milk, goat’s milk can still be problematic for those with lactose intolerance 33. There’s also no clear nutritional advantage to goat’s milk over cow’s milk, nor strong evidence that it’s significantly less likely to cause allergic reactions 34.

That said, if you can tolerate dairy, I agree that the real benefit may come from fermented dairy products—whether from cows or goats. For example, regular consumers of unsweetened yogurt may have higher levels of beneficial gut bacteria and lower markers of inflammation 35.

Myth: Sourdough Bread Trumps Other Types

Truth: While sourdough does undergo fermentation, which can break down gluten somewhat, the actual practical benefits—such as reduced digestive discomfort for people with irritable bowel syndrome (IBS), have not been properly proven 36.

Meanwhile, there’s good evidence that whole grains (including sourdough bread made from them) can reduce the risk of death, particularly from heart disease and cancer 10. So, the key takeaway is that choosing whole-grain options is the smart choice—whether sourdough or not.

A caveat: Some people struggle to digest high-fiber foods and grains in general. Everyone is different, so go with what feels right for you and your gut.

Myth: Wine Has Health Benefits

Truth: The Blue Zones™ diet promotes drinking 1–3 small glasses of wine daily while socializing, but this stems from the old ideas that moderate drinking has health benefits over abstaining. 

Newer research shows that having up to two drinks a day doesn’t lower the risk of death compared to not drinking at all. It also shows that drinking more than 0.8 ounces of alcohol for women (just over 1 wine glass) or 1.5 ounces for men (around 2¼ glasses) increases the risk of death from all causes 37. 

The social vibe might help, and it certainly helps to drink wine with meals. But if you don’t drink now, it isn’t sensible to start. 

The Blue Zones™ Diet: My Perspective as a Gut Health Clinician

The Blue Zones™ diet raises another concern for me—it can be problematic for people with gut sensitivities and common digestive issues like IBS and inflammatory bowel disease. While plant-based diets are theoretically disease-protective, I work with many clients for whom too many processed plant foods or high-fiber foods only exacerbate their symptoms.

For these individuals, we’ve found that diets like Paleo or low FODMAP—which eliminate common food triggers or troublesome fibers—tend to be more suitable, at least temporarily. As the gut heals and tolerance for a wider range of plant foods improves, we can help them transition to a more diverse diet.

How the Blue Zones™ Diet Compares With Mediterranean and Paleo

The Blue Zones™ diet has some similarities with both the Mediterranean and Paleo diets, which are two evidence-based diets popular with many of our clients 38. For example, all three diets stress the importance of eating whole, fresh, nutrient-dense foods while avoiding or limiting ultraprocessed foods and added sugar.

Currently, the amount and quality of research is higher for the Mediterranean and Paleo diets than it is for the Blue Zones™ diet.

For example, a meta-analysis found that the Mediterranean diet may be the most effective dietary pattern for improving cholesterol levels, and the Paleo diet may be best for reducing inflammation 38. 

The table below breaks down how a Blue Zones™ diet looks in comparison with the Mediterranean and Paleo diets.

Final Thoughts on the Blue Zones™ Diet

The core principles of the Blue Zones™ diet—eating a variety of plant foods, staying active, and fostering a sense of community—are solid. However, given that the blue zones concept itself is debated, we may be buying into a romanticized idea rather than an evidence-based reality.

Additionally, some of its specific dietary recommendations feel more cultural or anecdotal than science-backed. And if you have gut issues or food sensitivities, following this diet could leave you feeling worse—not thriving into old age but instead feeling unwell far too soon.

For a deeper dive into diet trends, check out my article on the research (or lack thereof) behind popular diets. You might also find my book, Healthy Gut, Healthy You, a helpful resource. And, of course, if you’re looking for personalized support, our experienced practitioners are always here to help.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.