Is Italy’s Cilento an uncharted ‘Blue Zone’?

In a recent review published on Nutrients, Researchers are using environmental, dietary and lifestyle data to determine whether Italy’s Cilento shares characteristics with the ‘Longevity Blue Zones’ (LBZs).

Study: A narrative review exploring the similarities between the Cilento and the already defined ‘blue zones’ in terms of environment, diet and lifestyle: Can the Cilento be considered an undefined ‘blue zone’? Image credit: Matthias Jiury Rabbione / Shutterstock.com

What are LBZs and what can they teach us?

LBZs, often referred to as “blue zones”, are areas around the world with different geographical profiles, but with a common life expectancy for citizens. These areas include Okinawa Prefecture, Japan, Nuoro Province, Sardinia, Italy, Nicoya Peninsula, Costa Rica, and Ikaria, Greece. However, many scientists assume that this list is not exhaustive, with other LBZs waiting to be discovered.

LBZs are of particular interest to scientists because, in addition to being home to the world’s oldest living people, these people rarely suffer from age-related complications. Previous studies aimed to elucidate the mechanistic basis of these observations and found genetics to contribute only 20–30% of the remarkable longevity of LBZ citizens. Thus, environmental factors, lifestyle choices, occupational habits, and dietary patterns are likely responsible for most of these observed benefits.

Cilento is an Italian region located in Campania, in Salerno, notable for the Mediterranean diet (MD), an increasingly popular dietary pattern consisting mainly of fresh fruits and vegetables, rich in dietary fiber, extra virgin olive oil and minimal meat. – or eating processed foods. Given the large number of non-elderly and centenarians living in the area, the Cilento is increasingly the subject of research focusing on longevity.

About the study

The present review aims to assess whether the Cilento deserves LBZ status in the future and whether environmental, dietary or lifestyle factors support longevity in the area.

The researchers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with model adaptation. Studies published from 2004 onwards were obtained from the online databases Scopus, PubMed/MEDLINE and Google Scholar.

Of the 173 records initially found, 72 duplicates were removed from the analysis. Title and abstract screening resulted in the exclusion of 77 records, while full-text screening excluded six studies, leaving a final data set of 18 publications.

The researchers used a descriptive comparative approach to compare and contrast features between the Cilento and current LBZs.

Study findings

Despite the geographic contrast between the Cilento and present-day LBZs, shared environmental, dietary, and lifestyle characteristics among these populations may allow the Cilento to produce longevity similar to the LBZ.

Environmental data suggest that hilly elevations ranging between 355-600 meters (m) above mean sea level (MSL) and a mild climate with an average annual temperature of 20 °C may contribute to longevity. In addition, the largest inhabitants of Cilento were concentrated at an altitude of 400-600 m, with the area corresponding to the average annual temperature requirement of 18-20 °C.

Despite the different historical and cultural origins, as well as species compositions, Cliento’s predominantly plant-based diet prioritizes the consumption of fruits, vegetables, legumes and grains with a low content of processed foods and fats. Similar to Okinawa, Japan, Cilento found ways to improve the nutritional content of potatoes, which were once considered less healthy than other plant foods, by using virgin olive oil boiling and seasoning techniques.

The Mediterranean diet is known to promote health, but it is also recognized that not all Mediterranean populations are equally long-lived. These data confirm that longevity is the sum of genetic and macro- and microenvironmental factors and not just the result of a single factor such as diet.”

Common lifestyle features include, but are not limited to, career and family arrangement choices. Residents of Cilento and other LBZs, excluding Loma Linda, are mainly engaged in traditional and labor-intensive employment, maintain a high respect for social and family structure, and exhibit high religious devotion.

conclusions

This review highlights the similarities and differences between Clientos and LBZs to determine whether Cilento meets the requirements to qualify as an LBZ. Most importantly, this review highlights environmental, dietary and lifestyle factors that may contribute to longevity, not only for residents of LBZs, but for the general population.

The lessons learned from this discovery could be applied to the general population to protect them from chronic non-communicable diseases and help slow the aging process.”