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The Place Where Men Live Longer Than Women

This is the fourth article in our Blue Zones series.

Today we will shine our Blue Zone ‘flashlight’ on Nicoya, Costa Rica.

Full of natural beauty, endless sunlight, white beaches and radiant ocean, Nicoya reigns as one of the most popular destinations in Costa Rica.

It is also one of the world’s Blue Zones.

While the population size in Nicoya is too small to track longevity with statistical significance, scientists have used an analogous indicator and calculated that the probability of a 60-year-old Nicoyan male becoming a centenarian is SEVEN times that of a Japanese male!

The obvious question is why?

To find out, let’s explore the puzzle of the Nicoyan Blue Zone together.

How Do We Know About Nicoya?

Our understanding of the Nicoyan population comes from four studies called the CRELES (Costa Rican Longevity and Healthy Aging Study).

The purpose of the studies is to better understand the length and quality of life (and what contributes to both) as it relates to the Costa Rican elderly. The research was conducted by the University of Costa Rica’s Centro Centroamericano de Población (CCP) in collaboration with the Instituto de Investigaciones en Salud (INISA).

Using a set of nationally representative longitudinal surveys, researchers covered a broad range of topics including physical and psychological health, living conditions, health behaviors, health indicators, and mortality.

The first three studies were called the CRELES Pre-1945, which looked at almost 3000 Costa Rican residents who were born in 1945 or before. The first study was baseline household interviews in 2005, and the next two were follow-ups in 2007 and 2009.

The fourth study was called CRELES 1945-1955 Retirement Cohort (RC); it examined Costa Rican residents born between 1945 and 1955 and included 2,800 long-form interviews plus 1400 interviews with their spouses.

Participants in this fourth study were interviewed in 2010 and then again in 2012.

It Is All About the Men

The studies revealed that, when it comes to longevity, Nicoya is not an equal opportunity employer.

In fact, it is for males only.

The research shows that longevity in Nicoya is independent of socio-economic position, and it also appears to be gender specific.

In other words, it is the Nicoyan men who were the most likely to enjoy long lives, not their female counterparts.

Which is exactly why Nicoya has been dubbed the ‘high longevity island for elderly males.’

Men’s advantage in living a long life comes from a lower cardiovascular (CV) mortality, i.e. they are dying less of cardiovascular disease.

The Gender Factor in Other Blue Zones

When you look at the Blue Zones, men and women do not always enjoy longevity equally.

In Okinawa, it is the women who live longer.

The average lifespan of Okinawan women is 86 years while their male counterparts live an average of 77.7 years, making Okinawa famous for being the ‘home to the world’s longest-living women.’

Simply put, Okinawan women who follow the traditional diet live longer than any other group on the planet.

When we turn to the Loma Linda Blue Zone, we see another pattern.  Both men and women in the Adventist population may live a decade or more longer than the general US population with an average of 83.3 and 85.7 years, respectively. However, the effects of modifiable lifestyle behaviors seem to be particularly beneficial for Adventist men.

As we explained in our article Living Long in Loma Linda, Adventist men live 6.2 years longer than non-Adventist men while Adventist women live 3.7 years longer than their non-Adventist counterparts.

Death rates from all cancers are 40 percent lower for Adventist men and 24 percent lower for Adventist women compared to non-Adventists. And the rate of coronary heart disease is 34 percent lower for Adventist men and 2 percent lower for Adventist women compared to non-Adventists.

So while Adventist men and women in Loma Linda both enjoy a much longer life than the average US citizen, lifestyle factors seem to be even more critical for men.

What Is the Nicoyan Secret?

What explains Nicoyan longevity, particularly the reduced propensity of the men to fall prey to cardiovascular disease?

To understand their secret, it is essential to look at diet first.

While the Nicoyan diet is not 100 percent plant-based, it is still rich in fruits and vegetables, and highly unprocessed.

It is filled with maize (corn) and beans (a powerful nutritional combination), and they consume a lot of colorful fruits like their beloved maranon, a red-orange cashew tree fruit that is bursting with vitamin C and antioxidants.

Moreover, their diet is notable for two reasons:

  1. Rich in Fiber: Nicoyans rely heavily on traditional foods such as rice and beans. They focus on consuming intact carbohydrates that are rich in fiber as opposed to refined carbohydrates which have been stripped of their fiber content. (It is important to note that refined carbohydrates make up 90 percent of the carbohydrates currently eaten by Americans).
  2. Low in Milk Consumption: The Nicoyan diet contains few dairy products, and they consume very low levels of milk. According to studies, this very well may help protect them against diseases like obesity and type 2 diabetes.

Guidelines for Living a Long Life

Beyond diet, other habits explain why this Costa Rican Pacific Coast peninsula is so far ahead in the longevity game.

Here are nine principles Nicoyans adhere to:

  1. Have a Reason to Live: The Nicoyan elderly have a reason to live (‘plan de vida’) which keeps them positive, upbeat and happy. They feel needed and enjoy a sense of purpose.
  2. Focus on Family (and Friends): Camaraderie and the comfort of family give the elderly a strong support system and an active social life filled with listening, laughter and gratitude.
  3. Follow Their Faith: The Nicoyans are deeply linked to their traditional Chorotegan roots and have a strong belief in God. Their sense of connectedness and ‘faith routines’ serve to relieve stress and anxiety.
  4. Drink Water: The water they drink is ‘hard water,’ containing high amounts of calcium and magnesium.
  5. Eat a Light Dinner: In Nicoya, they eat their biggest meal during the day and smallest meal at night. We saw this same habit in Loma Linda. It appears that eating fewer calories later in the day is one of the surest ways to add years to your life.
  6. Stay Physically Active: Nicoyans engage in moderate physical activity on a daily basis, including walking, bicycling, gardening, cooking, keeping up the house and taking care of the animals.
  7. Enjoy the Sunshine: The Nicoyans get healthy doses of daily sun, enriching their body with vitamin D, a vital nutrient that is essential for healthy body function and strong bones.
  8. Sleep: The Nicoyans sleep an average of 8 hours per day, waking with the sun and going to bed at nightfall.
  9. Avoid Cigarettes: As in the other Blue Zones populations, the Nicoyans do not smoke.

This list once again illustrates that the Blue Zones share certain lifestyle habits that allow them to access the ‘fountain of youth.’

And as always, we see that a diet centered on whole grains and other plant foods plays an important role in living a long and healthy life.

Rosane Oliveira, DVM, PhD

President & CEO, Plant-Based Life Foundation | Dr. Rosane Oliveira combines a lifelong passion for nutrition with 25 years of genetics research to create programs that help people develop healthy habits on their journey towards a more plant-based lifestyle. She is a Visiting Clinical Professor in Public Health Sciences and was the founding director of the first Integrative Medicine program at the UC Davis School of Medicine. She completed her postgraduate studies in Brazil and did her postdoctoral training in immunogenetics and functional genomics at the University of Illinois at Urbana-Champaign.