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In recent months, we have talked a lot about the Blue Zones: five geographic locations known for longevity because of their healthful eating and lifestyle habits.

To quickly review our journey, here are the six articles of our series:

  1. How to Enter the Blue Zone
  2. The Okinawan Way (Important Lessons About Diet and Longevity)
  3. Living Long in Loma Linda
  4. Blue Zone: Nicoya, Costa Rica (The Place Where Men Live Longer Than Women)
  5. Sardinia’s Centenarian Secrets
  6. Insights From Ikaria (What a Tiny Greek Island Can Teach Us About Living Long)

In the articles, we also examined how many of the traditional diets of the regions have eroded in recent years. This is particularly true of the Mediterranean diet.

As luck would have it, I found myself traveling through the Mediterranean region in the last five weeks—including long stays in Italy and Greece.

Given that my trip followed on the tail of our Blue Zones discussion, I decided to share some of my first-hand observations of the region’s eating and lifestyle habits today.

My Journey

Before I begin, I would like to add two caveats.

First, while I visited both Italy and Greece, I did not visit the exact Blue Zones that we discussed.

While the Italian Blue Zone is Sardinia, I stayed farther northeast, visiting Tuscany, Umbria, Piedmont, and Liguria, including the Italian Riviera.

In Greece, I stayed in Crete, the place where the Mediterranean diet was first described by Ancel Keys. However, I did not experience the Blue Zone of Ikaria.

Secondly, I am keenly aware that as a tourist/foreigner, it is often difficult to get a full understanding of how local people really live.

For example, while in Greece, I stayed in a resort hotel far from the locals’ day-to-day-life. While in Italy, however, I had the great fortune to witness ‘local life’ from close range.

The Bad News

Before I explain the positive lessons learned, I should share one unfortunate observation.

And it pertains to smoking.

As we discussed in previous articles, the Blue Zones are linked by a common lifestyle habit—people in these regions are not usually smokers.

What I witnessed during my five weeks is that this ‘no smoking’ rule appears to still apply to the older generation (i.e. those in their 70s, 80s, and 90s).

On the other hand, the young generation smokes a lot.

Wherever I went, the number of young people smoking struck me. Every restaurant, every bar, was filled with people in their 20s and 30s lighting up cigarettes.

I also saw a lot of middle-aged people (in their 50s and 60s) smoking.

Since smoking is the #2 risk factor linked to premature death and disability in the US (second only to diet), this is a disturbing trend that has serious health implications for the region.

The Good News

Now for the good news and the five lessons I learned:

1. Grilled Vegetables Are Everywhere.

I was incredibly pleased with the fact that I could find grilled vegetables (verdure alla  grilia) and potatoes and/or leafy greens as sides in every single restaurant.

What really impressed me (which I totally did not expect) is that the vegetables were grilled without ANY oil. They were either served plain, or with olive oil drizzled over them (meaning you could easily request no oil).

This is a far cry from the US where grilled veggies almost always arrive drenched in oil and restaurants often argue that it is ‘impossible’ to grill them without oil. I was delighted to see that grilling without oil is the norm in Italy.

Also, while olive oil was present everywhere, it usually comes in small quantities, making it possible to limit intake.

2. Soups Are Popular.

Many restaurants offered minestrone soups made with leafy greens, beans, potatoes and/or pasta.

No soup tasted the same, and I had so much fun sampling all the unique varieties created by the different restaurants!

3. Plant-Based Pasta and Pizza Is Plentiful.

For those of you who eat whole grains, you will be interested to know that every single restaurant offered pasta with different varieties of tomato sauce (pasta con pomodoro). They also served many types of bruschetta—toasted Italian bread topped with garlic and tomatoes.

When it came to pizzas, I was surprised to discover that many pizzerias offered whole grain crusts and had no problem serving them without cheese. Even when pizzas were prepared with cheese, it was a fraction of what is typically used here in the US.

Similarly, no pasta dish (or soup) was ever served with cheese. The Parmigiano-Reggiano regularly found on food in US restaurants appears ‘on the side’ in Italy, making it easy to avoid any unwelcome cheese surprises.

4. Fruit Is Always Available as a Dessert.

Just like Ancel Keys saw back in the 1960s, fruit continues to be a favorite way to end a meal.

Almost every restaurant in Italy offered pineapple as dessert. In Crete, fruit like watermelon and cherries was always brought to the table (along with baklava and other famous Greek sweets).  Fruit was also a staple in breakfast and dinner buffets.

5. Healthful Lifestyle Habits Are Abundant.

Beyond food, I saw that some of the Blue Zone lifestyle habits have not disappeared:

  • Friends and Community Are Important: In our days in Italy living among the locals, I noticed that the older people would gather around 5 pm to walk, talk and enjoy the outdoors and the company of friends. Even more surprising, they were not drinking—simply spending time together.
  • Mealtime Is Sacred: At lunchtime, everything shuts down. I remember when I first visited Italy in 1995, the stores would close for 2-3 hours midday. That habit is still present—at least in smaller towns. It underlines the importance of eating at home with your family and resting before heading back to work.
  • Family Is the Center of Social Life: Throughout our Blue Zones series, we saw that these communities focused heavily on the family. Apparently, family still reigns supreme. I noticed whole families going out to walk and eat together. We saw a street festival in Rapallo filled with music, art, and food, with entire families participating. Other times, we witnessed three generations at the table. While you can still see some of this in the US, it appears to be more common in places like Italy and Greece.
  • Being Active: People engage in physical movement all the time, without having to go to the gym! Even the older generation is constantly ‘out and about,’ whether they are walking to the shops, meeting with friends at 5 pm by the shore, or going out with the family. One Sunday afternoon, we watched eight friends (all in their early 80s) playing bocce for hours!

As we pointed out repeatedly in our Blue Zones articles, it is clear that the Mediterranean diet and lifestyle have changed a lot in the last six decades. Despite these changes though, it is still possible to find healthful lifestyle habits and good plant-based diet options in the region.

Apparently, we can learn a lot from the Mediterranean, both then and now!

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.