Nuoro, a Sardinian province, specifically within the Barbagia of Ollolai and the Ogliastra mountains, that holds a demographic paradox that fundamentally challenged our understanding of human longevity. The village of Seulo, in particular, perched high among granite peaks, once held the world record for the highest concentration of centenarians – residents who routinely lived past 100 in remarkable health, free from many diseases that plague modern societies.
Nuoro is not just the capital of its province but a cultural powerhouse known as the “Sardinian Athens,” having produced numerous renowned artists including Nobel Prize winner Grazia Deledda. This city of roughly 36,000 residents holds special significance in Italian culture, with its borough of Lollove recognized as one of “The Most Beautiful Villages of Italy” and its museums ranking among Sardinia’s most important cultural institutions. Besides being a cultural powerhouse, this Mediterranean land harbors the world’s first identified Blue Zone – a term born from the blue pen marks that researchers Dan Buettner and Dr. Gianni Pes used to circle clusters of villages with extraordinary concentrations of centenarians.
Their longevity, however, isn’t a story of stress-free lives. As Dr. Pes emphasizes, “It is incorrect to say that the centenarians of the Sardinian Blue Zone have never experienced stress. We must keep in mind that many of them participated in the First or Second World War, often risking their lives… In the 1950s and 1960s, they often had to emigrate to various European countries; they had to adapt to another way of life and culture, as well as learn a foreign language.” What makes these centenarians remarkable is not the absence of hardship, but their resilience in the face of it. For much of the twentieth century, the relationship between longevity and economic prosperity seemed straightforward. As Dr. Pes explains, scholars like Albert Evans had built their reputations on the “social gradient theory of life expectancy,” which directly linked economic well-being to longer lifespans. Yet after three decades of documenting this extraordinary phenomenon, Pes’s research revealed a compelling contradiction. “The Sardinian Blue Zone study questions this framework, suggesting that some degree of underdevelopment, linked to later and slower modernization, along with maintained traditional lifestyles and eating habits, may have favored longevity.”
What sets this region apart is not just its challenge to economic theories, but its unprecedented concentration of male centenarians, a demographic typically underrepresented in longevity statistics worldwide. This distinction points to something extraordinary in the intersection of genetics, lifestyle, and culture, from the unique properties of local Cannonau wine and pecorino cheese to the enduring impact of traditional pastoral life. As Dr. Pes observes, these centenarians represent perhaps the last generation to age without digital stress, protected by strong family bonds – “many centenarians still live with their children” – raising profound questions about how future generations will achieve such longevity in our increasingly digital world.
Intelligence Encoded into Simple and Traditional Dietary Patterns
Many longevity researchers focus on the Mediterranean diet, but the traditional Sardinian diet has unique aspects. Could you elaborate on the key differences and their potential impact on longevity?
The fact that Sardinia is located in the Mediterranean area has led to the belief that the Mediterranean diet is one of the factors responsible for the exceptional longevity of its inhabitants. However, there are substantial differences due to the strong legacy of the pastoral culture based on livestock breeding. The diet in the Sardinian Blue Zone left ample space for plant-derived foods (the famous minestrone of legumes and potatoes) together with the moderate consumption of products of animal origin, although dairy products prevailed over meat. The latter was traditionally not consumed more than 4 times a week. Dairy products, especially the fresh cheese called casu ajedu, were consumed daily. These fermented cheeses are rich in lactic acid bacteria that produce numerous beneficial substances, such as butyric acid, which has shown anti-cancer properties, especially in the colon.
Modern nutrition often focuses on individual nutrients and foods. However, your research emphasizes the importance of food combinations in the traditional Sardinian diet. Could you explain how certain combinations might enhance longevity benefits?
The importance of food combinations is not only a characteristic of the Sardinian diet but also that of the other populations living in the Blue Zones. For example, in the food culture of Okinawa, particular emphasis was placed on food mixtures rather than on single foods. Mixed dishes included both plant and animal products (for example, garlic, carrots, and pork liver, or vegetables and freshwater fish). In Sardinia, intelligent use of all the edible parts of the pig was traditional, including the tail, legs, ears, internal organs, blood, and fat. Lard chunks were added to vegetable minestrone (which was never entirely vegetarian). Intake of potatoes together with olive oil (or even lard) was helpful as it reduced the glycemic index of potatoes. These tubers are often considered unhealthy because they tend to raise blood sugar levels, but it is known that boiled potatoes, together with seasoning fats, have a much lower glycemic index. Traditional Sardinians knew this well, and despite the frequent intake of potatoes, they very rarely developed metabolic diseases such as diabetes. The association of pasta with beans helped to remedy the deficiency of the amino acid lysine in pasta. Lysine is an essential amino acid for the synthesis of collagen and, therefore, for the health of connective tissues and skin, and it is also used to produce antibodies that provide immune defenses.
Could you discuss the role of seasonal eating patterns in Sardinian longevity? How does this contrast with our modern ability to access any food throughout the year?
The traditional diet in Sardinia was seasonal and therefore very different from what we are used to today. In the past, food was rarely purchased but was mostly self-produced and at most exchanged between families. Eating seasonal foods while respecting natural cycles determined significant variability in the diet throughout the year. It represented a corrective to the rather monotonous regime imposed by the organization of pastoral society. Seasonal foods were harvested and consumed fresh. They were, therefore, richer in vitamins and antioxidants. In Sardinia, shepherds ate prickly pears widespread in the countryside that ripened between May and June. A little later, between August and September, figs ripened, whose trees were common in the vineyards that almost everyone owned. In autumn, apples (including wild ones) and pumpkins were consumed. However, we should not think that fruit was brought to the table during meals and consumed daily. Consuming wild fruit at the right times of the year was much more widespread. This fruit was rich in fiber and helped maintain health and limited excessive absorption of fats.
Pecorino is a regional treasure in Sardina, might it have something to do with longevity?
Studies conducted by us and other research teams revealed that Sardinian pecorino contains potentially beneficial molecules for human health. In particular, a fatty acid called conjugated linoleic acid (CLA) is formed through the action of bacteria in the ruminants’ stomachs and then passes into milk. Recent research indicates that CLA reduces body fat and facilitates excess fat loss. Furthermore, medium-high doses of CLA can reduce cholesterol levels in experimental animals. Evidence indicates other possible beneficial properties of CLA regarding immune function, the cardiovascular system, and blood sugar level. A study published in 2021 by us showed that in elderly people ”living in the Sardinian Blue Zone, the level of CLA in the blood is higher than in young people and elderly people living in the rest of the island. It could be the first biological marker of longevity identified in Sardinia.
Social & Cultural Dimensions
Your studies have shown that Sardinian centenarians maintained strong social bonds throughout their lives. In our increasingly digital world, how can we replicate the benefits of these traditional social structures?
I don’t think it is possible for us to imitate the lifestyle of the centenarians of the Blue Zone in the hope of becoming as long-lived as them. The life of the elderly Sardinians has been very different from how we live; there is a historical and cultural barrier that makes it impossible to transfer the experience of the centenarians into our lives. We can only try to isolate some particularly relevant aspects of the lifestyle of the Blue Zones and try to adapt them to our post-industrial society. Living life actively certainly has its importance. We must try to move more and keep our bodies in action. Giving up using cars (if possible) and elevators is the first step to reducing a sedentary lifestyle. This is easier if we live in relatively small urban contexts, not if we live in a metropolis. We should pay more attention to what we eat, dedicating a little more time to reading the labels of the foods we buy in supermarkets. We should spend more time with family or friends, participating in collective activities that promote interpersonal exchanges, emotionally relevant, as centenarians did in the Blue Zone. Above all, we must find a purpose to our existence that helps us not to fall prey to despair when we encounter the inevitable difficulties that seem to wound our souls (grief, illnesses) deeply.
Sardinian centenarians often worked well into old age, how does this contrast with modern retirement patterns, and what implications might it have for healthy aging?
Until the 1960s, the inhabitants of the Sardinian Blue Zone did not retire. Since they were primarily farmers and shepherds, they continued the same activity up to 80, obviously with less intensity. I have known shepherds who followed the flocks until they could no longer leave the house due to mobility difficulties. Since they were transhumant shepherds (a seasonally-mobile shepherding), they were used to walking for long hours every day. They often went up from the plain to the mountain huts located at over 1800 meters on the island’s central massif. If they were farmers, they looked after the vegetable garden (which also provided them with much of their daily food). It was often not behind the house but was several kilometers away from the house outside the village and was regularly reached on foot. During the winter, the village men walked even 10-20 kilometers following the flocks, so the women remained alone in the village and had to take on heavy work, such as fetching firewood. To do this, they walked for kilometers. However, neither male nor female jobs were a source of stress. Since the 1960s, many shepherds and farmers have preferred to change occupations and become workers. This has allowed them to access the pension system and ensure more secure aging that was previously entrusted exclusively to family care.
Your research has shown interesting gender differences in longevity patterns within the Sardinian Blue Zones. How do traditional gender roles and activities contribute to these differences, and what can we learn from this?
Our research on Sardinian longevity revealed unexpected gender equality in centenarian probability. Literature shows that in most populations, except small communities in Iran, India, and Nepal, women outlive men by 5-7 years – the survival “gender gap.” Migration factors can be excluded, as male migration was more frequent in Sardinia. Gender differences may stem from occupational and lifestyle variations. In the Blue Zone, men were mostly shepherds while women managed domestic tasks, including animal husbandry and agriculture. Men typically engaged in more intense physical activity throughout life, enhanced by the mountainous terrain. Women managed property and transmitted ethical values, experiencing more stress. Men’s traits like high extroversion and sociability, plus better adaptation to modernity, may have positively affected longevity through lower cardiovascular mortality. Central Sardinia maintained a matriarchal organization until industrialization in the 1950s. Women’s increased workload during men’s seasonal absence, while not granting real power, likely contributed to higher chronic stress, potentially reducing female longevity. Older men received intense family and community attention, supporting longevity. They often married younger women, avoiding widowhood’s negative impact, and remarried more frequently. After widowhood, women typically lived alone while men lived with unmarried children, as nursing homes were uncommon, further favoring male longevity.
The role of stress management differs significantly between traditional Sardinian culture and modern society. How do you see the impact of digital stress and constant connectivity on longevity potential compared to the stresses faced by centenarian communities?
We must keep in mind that many of them (centenarians) participated in the First or Second World War, often risking their lives, as well as other wars during the fascist period. In the 1950s and 1960s, they often had to emigrate to various European countries (mainly France, Belgium, and Germany); they had to adapt to another way of life and culture, as well as learn a foreign language. The time spent in school was very limited (on average 3-4 years), so education was minimal. The centenarians who are alive today were already too old when the spread of digital technology began, and so far, their lives have not been much affected by this revolution. I have only met a few centenarians who used the computer regularly and competently. A slightly higher number regularly used the mobile phone, with some difficulty using the keypad due to vision problems. I believe this generation of centenarians will disappear without ever having experienced real digital stress. The same cannot be said for those who will become centenarians in the coming decades. No one can make predictions, but it is hoped that the role of the family (many centenarians still live with their children) can act as a buffer against the stress resulting from pervasive digital technology in their lives.
Your research has highlighted the high concentration of centenarians in Sardinia’s mountainous regions. Beyond genetics, what specific environmental factors in these areas might contribute to exceptional longevity?
Various hypotheses have been put forward. The most interesting environmental variable is the slope of the terrain. Being a hilly area, the Blue Zone forces most people to work outdoors, moving on foot and spending more energy throughout the day. In the long term this prevents the accumulation of harmful fat and strengthens the muscles and cardio-respiratory fitness. Many Sardinians who reached the age of one hundred were shepherds and moved outdoors, covering up to 10-20 kilometers a day. The environment of the Sardinian Blue Zone is also rich in wild plants many of which are edible and rich in antioxidants, which protect the body from the attack of free radicals responsible for aging.
Dr. Gianni Pes is currently an Associate Professor at the University of Sassari, affiliated with the Department of Medical, Surgical and Experimental Sciences. Co-founder and president of the “Sardinia Longevity Blue Zone” Observatory, he has been serving as Director of the Sassari Center for Atherosclerosis Studies since 2012. He was featured in the Netflix series “Live to 100: Secrets of the Blue Zones.”
