Nutrition and Longevity: Clues from The Blue Zones

Caitlin Beale, MS, RDN

Since the dawn of the so-called fountain of youth, humans have been searching for ways to live longer and healthier lives. While there isn’t a magic potion that will make us live forever, specific characteristics and habits do seem to extend the lifespan. 

In his book and research on “The Blue Zones,” author Dan Buettner discusses the top five areas of centenarians (someone who lives to the age of 100 or older) worldwide. These people have been documented to live longer, healthier lives than their peers in other parts of the world.

There’s no single answer to longevity, but people in these areas seem to embrace the right lifestyle habits. Not only do they live long lives, but they live them well.

So what are the habits, and why do they help so much?  This blog will focus on the diet patterns associated with longevity, so you can implement some of these practices into your own life.

What are the Blue Zones?

The blue zones include five regions where people live exceptionally long lives (over 100 years). These regions are: 

• Okinawa, Japan

• Sardinia, Italy

• Nicoya Peninsula, Costa Rica

• Icaria, Greece

• Loma Linda, California.

Each location has more than ten times the number of people over the age of 100 compared to the United States. But as mentioned, these residents don’t just live longer. They enjoy health throughout life with lower rates of dementia while working and being physically active well into older age.

Dan Buettner, the author of the Blue Zones, partnered with scientists to dig deep into the secrets of the people from these areas. The team who worked on Blue Zone research cites the Danish Twin Study that indicates that genetics influence lifespan by only about 20 percent, while the remaining 80 percent is determined by lifestyle.

9 factors have been listed as contributors to healthy aging:

• Movement is a normal part of life (not just going into gyms for 30 minutes a day).

• A sense of purpose in their lives.

• Stress management and resilience.

• Recognizing feelings of fullness and stopping when 80% full to prevent overeating (also known as hara hachi bu in Japan).

• High fiber, plant-focused diets.

• Moderate daily wine intake.

• A feeling of community and belonging.

• Families and loved ones are a priority. 

• Social networks that share similar healthy behaviors. 

What are the nutrition habits for people in the Blue Zones?

As indicated above, the Blue Zone diets are primarily plant-forward. Some include meat, but unlike the plate of many Americans, it is not the feature of the meal.  In almost every blue zone region, whole and ancient grains are also a large part of their meals.

These and many other traditional diets include very little processed food with few commercially prepared products like soda, sugary beverages, or fast foods. Instead, food is freshly prepared, with a focus on seasonal patterns and what is available locally.

Studies on the Seventh-day Adventists in the Loma Linda region associate the vegetarian diet with lower obesity and cardiovascular disease rates. Both of these conditions are related to accelerated aging and loss of quality of life.

But you don’t necessarily need to be completely vegetarian. Some regions include small amounts of meat, poultry, and fish as part of their diets. For example, eating fish can contribute to longevity and reduce the risk of overall mortality, according to a study in the Journal of Internal Medicine. 

The key is that meat, while part of some Blue Zone diets, is not a staple like it typically is in American meal plans.

What foods support healthy aging?

Based on the habits of people in the Blue Zones, the following foods are highlighted:

• High-fiber vegetables. The wide array of vegetables in the Blue Zone diets provide fiber, vitamins, minerals, and phytonutrients. These nutrients are all linked to lowered levels of inflammation, antioxidant activity, and healthy weight maintenance. Aim for five to seven servings of brightly colored veggies each day.

• Healthy oils. Olive oil, avocados, and nuts are helpful for healthy aging. They contain monounsaturated fats linked to healthy cholesterol levels, blood pressure, and a reduced risk of heart disease. Omega-3 fatty acids found in fish, nuts, and seeds are also associated with healthy aging and cognitive health, as highlighted by a study in the Journal of Human Nutrition and Dietetics. 

• Legumes. Beans, peas, chickpeas, or lentils are staples of Blue Zone dietary patterns. Not only are they sources of plant-based proteins, but they are also high in fiber which could help balance glycemic control. Blood sugar dysregulation with high insulin levels is associated with mitochondrial dysfunction, negatively impacting the aging process.

The traditional diet of Costa Ricans, rich in rice and beans, is associated with increased telomere length. Telomeres are found on the ends of your chromosomes and help protect your cells against the aging process.

• Nuts and seeds. Nuts and seeds are packed with protein, fiber, minerals, and healthy fats that help you feel full until your next meal. They also contain antioxidants that help fight aging-related diseases by protecting cells against damage.

• Whole grains. Whole grains like bread, brown rice, or quinoa are all associated with a lower risk of heart disease, diabetes, and obesity. Whole grains are also packed with health-promoting fiber that contributes to optimal blood sugar control.

• Fermented foods. Fermented foods like kimchi, sauerkraut, yogurt, cheese, miso, natto, and kefir—found in most blue zone dietary patterns—support gut health. They contain probiotics, live bacteria that help replenish your gut flora. 

Studies are now pointing to a connection between a healthy population of different types of gut bacteria and healthy aging. One study published in Nature found that older adults living in long-term care facilities had significantly less diverse gut bacteria. Further, less diversity was associated with increased frailty and poor health status.

What other eating habits may support healthy aging?

Aside from the specific foods eaten, people in the Blue Zones participate in eating behaviors that may help explain their longevity and health.

First, food is often grown or raised in the community, supporting fresh, unprocessed foods. While this isn’t always possible, you can consider shopping at a local farmer’s market.

Eating is also social, a daily ritual that signals the change of pace. Enjoying food with friends and family is a regular event in the day versus eating at a desk or in front of the television. Research from BMC Public Health indicates that people who use screens the most report unhealthy dietary patterns and rate their health lower than moderate or light users.

How are fasting and calorie restriction connected to longevity?

People in the Blue Zones may also eat fewer calories overall, which can influence longevity. A study on older Okinawans found that low-caloric intake was often part of a typical eating pattern.   

Additionally, many of the people in the Blue Zones participate in regular fasting for religious reasons.

Calorie restriction (long-term, not for crash diets) and fasting are both associated with longevity. Both may induce autophagy, the body’s natural process to clean out cellular debris and repair damaged cells. 

Autophagy can act as a DNA repair mechanism important to longevity. According to a review in Frontiers in Cell and Developmental Biology, autophagy is a potential weapon against age-related deterioration.

Fasting also supports mitochondrial health by increasing NAD+. NAD+ is associated with healthy mitochondria and aging benefits.

Bring the Blue Zone to your kitchen.

You can use the above dietary patterns and habits to bring some of the Blue Zone practices into your everyday life. Simple changes like adding more vegetables, swapping processed meats for legumes, and focusing on fiber can all make an incredible difference in your health. 

Sharing your healthy diet with friends and family or practicing intermittent fasting could take your habits even further. If it feels like you have many changes to make, choose one to start with and continue to add more once it becomes a habit. Small changes really do add up over time.

Nicotinamide riboside is a micronutrient that effectively increases your levels of NAD+, or nicotinamide adenine dinucleotide. It’s essentially a form of vitamin B3, but is structurally and biochemically different from niacin and nicotinamide, the other forms of vitamin B3. 

What is NAD+?

NAD+ is a coenzyme, working as an essential partner in cellular energy production. As a coenzyme, NAD+ works alongside several enzymes in the mitochondrial membrane, hence the prefix “-co” in its name. They are your enzyme’s best friend, helping fuel the “cellular machine” that creates the energy needed by every major function in your body on a cellular level.

Due to its critical role in cellular energy production, the absence of NAD+ in your body would render most bodily functions useless. Without NAD+, your lungs wouldn’t be able to draw in oxygen, your heart wouldn’t be able to pump blood, and your brain synapses wouldn’t be able to fire.

NAD+ also has a secondary job of importance outside of cellular energy production. NAD+ helps facilitate DNA repair and regulate cellular activity by working with sirtuins and poly (ADP-ribose) polymerase (PARPs), key enzymes involved in regulating cells’ response to damage from things like overeating, drinking, lack of sleep, lack of exercise, and sun exposure. 

Why is NAD+ a big deal?

Research in 2012 from a team at the Department of Pharmacology at the University of New South Wales showed age-associated changes in NAD metabolism. The study revealed NAD+ levels decline by up to 50% in human skin tissue between the ages of 40-60 and that NAD+ depletion may play an important role in the aging process. In the paper, the researchers stated, “A strong negative correlation was observed between NAD+ levels and age in both male and females.”

In addition, NAD+’s involvement in cellular respiration, particularly in the mitochondria, contributes to overall mitochondrial health. One of the hallmarks of aging is a process known as “mitochondrial dysfunction”, which is linked to many age-related conditions. In recent years, research has focused on gaining a better understanding of NAD+’s role in addressing these mitochondrial-related problems.

How does nicotinamide riboside work?

Nicotinamide riboside is a precursor to NAD+, meaning that it serves as a “building block” to make the NAD+ molecule. Nicotinamide riboside is like a starter molecule, your body uses it to build the NAD+ molecule on its own. 

Supplementation with nicotinamide riboside is clinically proven to increase NAD+ levels. It turns out that this is more effective than supplementing with NAD+ itself. NAD+ is a very large molecule that is unable to enter the cell directly. Rather, your body must first break it down to smaller pieces before passing through the cell membrane. The pieces are reassembled on the inside of the cell. The breakdown and reassembly makes the process less efficient at increasing NAD+ in the cell.

Also, in capsule form, NAD+ as a straight ingredient degrades quickly when exposed to light and heat. An FDA briefing document denotes the molecule’s inability to survive in a capsule form under ordinary storage conditions.

Compared to straight NAD+, nicotinamide riboside can enter the cell directly without requiring a breakdown. 

Where do we get nicotinamide riboside?

Nicotinamide riboside is naturally found in minute quantities in dairy milk and yeast. You would have to consume a lot of milk to achieve any noticeable difference in nicotinamide riboside in your diet. For example, the amount of nicotinamide riboside in a 250-mg supplement is more than 1,000 times the amount in an 8-ounce glass of milk. 

Currently, the best way to take nicotinamide riboside is in supplement form. The recommended serving size is 300mg per day. A study published in Scientific Reports indicates that NAD+ levels will be significantly elevated after two weeks.

How safe is nicotinamide riboside?

There are several supplements on the market that have nicotinamide riboside as an active ingredient. However, ChromaDex, the patent holder of Niagen®—a proprietary form of nicotinamide riboside, is the only form that has been successfully notified to the Food and Drug Administration (FDA). Niagen® is the subject of a total of three FDA safety notifications whereas other nicotinamide riboside supplements hold none.

Niagen® is also the only form of nicotinamide riboside that has been successfully reviewed twice under the FDA’s New Dietary Ingredient Notification (NDIN) program. Achieving FDA acceptance of an NDIN is a major accomplishment as it is a highly rigorous process. Very few companies that do submit an NDIN to the FDA receive a no-objection. 

Niagen® is also the only form of nicotinamide riboside to be successfully notified to the FDA as Generally Recognized As Safe (GRAS). A FDA no objection to a GRAS notification is a recognition of the quality of the science and the safety of the ingredient.

As for products on the shelf, Tru Niagen®, ChromaDex’s consumer product of nicotinamide riboside, bears the NSF Certified for Sport® seal. The Certified for Sport® certification includes current Good Manufacturing Practice (cGMP) certification of the Tru Niagen manufacturing facility, and testing to confirm the absence of over 270 athletic banned substances and harmful contaminants like lead and arsenic.

cGMP regulations require manufacturers to take proactive steps to guarantee the identity, strength, quality, and purity of their products.

In addition to the US, Niagen® has achieved regulatory acceptance in Canada, the European Union and Australia.

So although there are several forms of nicotinamide riboside, Niagen® is the only patented form that has gone through the regulatory procedures to ensure safety in key markets around the world. The safety of other forms is unclear and unpublished. 

How does it compare with other NAD-boosting supplements?

We know the best way to increase your NAD+ is by supplementing with a precursor, however, there are several NAD+ precursors on the market other than nicotinamide riboside. How do you know which one is best for you?

Specifically, in comparison to other forms of vitamin B3, such as niacin or nicotinamide, nicotinamide riboside bypasses several steps that niacin and nicotinamide have to go through in the creation of NAD+. Tryptophan is an amino acid that also converts to NAD+, however, it takes a six-step pathway to get there. Tryptophan takes the longest route to increase your NAD+ levels. 

In a speed and availability comparison, nicotinamide riboside is the fastest way to increase NAD+ due to its simplicity in building NAD+. It’s more readily used by your body than any other NAD+ precursor.

Also, some precursors have notable side effects. Niacin can cause skin flushing, burning sensations, and itching. In comparison, its successor, nicotinamide, has no visibly noticeable side effects and is actually an effective NAD+ booster. However, nicotinamide can inhibit sirtuin activity, negatively impacting a different function in your cells that promotes and supports mitochondrial health and cellular repair.

Nicotinamide mononucleotide, or NMN, is often pitted against nicotinamide riboside. However, NMN is still largely untested in humans with only one published clinical study that did not report any effects of NMN on NAD+ levels. A study published in Nature Communications on NMN’s metabolism in mammalian cells states that NMN cannot enter your cells directly, and must convert into nicotinamide riboside before it enters.

It’s also important to note that niacin and nicotinamide have been around for many years and appear in many different products, such as multivitamins and breakfast cereals. As such, the FDA considers these vitamin B3 forms to be safe and has “grandfathered” their use. Nicotinamide riboside and NMN, however are much newer, and don’t enjoy the long history of use as the other vitamin B3s. But unlike Niagen®, NMN has not been subjected to any regulatory review by any authoritative government body anywhere. Therefore, the safety of NMN as a NAD+ precursor supplement is unknown and unproven at this time.

The future of nicotinamide riboside.

Nicotinamide riboside is unique in that your body can readily use it as a resource for NAD+ production. It’s benefits are not limited to mitochondrial health and sirtuins. General interest in NAD+ has garnered more interest in NAD+ precursor research as a whole, bringing nicotinamide riboside into the conversation. Many studies are underway surrounding the positive effects of nicotinamide riboside on other health issues. Studies examining the effect of nicotinamide riboside on brain health, muscle function, and heart health are also in tow. 

Nicotinamide riboside continues to be the one ingredient at the center of the NAD+ conversation with several completed human trials and many more underway. It’s only a matter of time before nicotinamide riboside starts to raise possibilities as a more holistic approach to maintaining general health.

Often dubbed the "healthy aging" vitamin, nicotinamide riboside (NR) is a novel form of vitamin B3 that improves the way we age.  

To understand how we age, we have to look at our bodies' underlying core processes. As we age, our bodies slow down. Our joints ache, our muscles grow weary, and the way we sleep and eat changes.  

But the true culprits of how we age lie deep within our cells. Cells are the foundation of our biology, and improving their efficiency may hold the key to answer the fundamental question, "Is there a way for us to reverse aging?"  

Nicotinamide riboside (NR) supports our mitochondria.     

No miracle pill reverses aging, but scientists began investigating a specific organelle in the cell, called the mitochondria.  

Research shows we make fewer mitochondria as we age and have attributed mitochondrial dysfunction as one of the hallmarks of aging.  

You may remember mitochondria from your high school biology class. These tiny yet powerful factories are responsible for producing 90% of your cell's energy. Without our mitochondria, we would not exist as the complex organisms we are today.  

Vitamin B3 is a necessary nutrient that supports normal mitochondria function. Although there are other variants of vitamin B3, nicotinamide riboside is the most efficient form, like premium-grade fuel at a gas pump.   

Nicotinamide riboside (NR) boosts NAD+ effectively.  

A significant reason why nicotinamide riboside is closely associated with aging research is because of the vitamin's unique ability to increase NAD+ efficiently.  

NAD+ is required for specific enzymes in your mitochondria, playing a direct role in your cell's energy creation.  

Unfortunately, there is evidence to suggest that age has a direct correlation to our NAD+ levels. Research from the University of New South Wales uncovered NAD+ levels decline by over 50% between the ages of 40 and 60, and low levels of NAD+ are linked to mitochondrial inefficiency.  

Thankfully, a review paper published in the Translational Medicine of Aging shows the positive potential of boosting NAD+. The review states,  

"NAD+ replenishment may serve as a potential therapeutic strategy for aging and  multiple conditions to improve the quality of life of the increasing aged population."  

Why don't we take more NAD+?  

Unfortunately, it's not so simple. NAD+ is very difficult to maintain in capsule form, and there are questions around its potency as a supplement. The molecule quickly degrades when exposed to light and heat and deteriorates when exposed to water.  

Even if it were to maintain its pill form, your body doesn't appear to take NAD+ as readily. A paper in the Journal of Nutritional Science and Vitaminology shows that our digestive process breaks down orally-administered NAD+ into common NAD+ precursors before the cells get a chance to absorb it.  

To simplify the process for our bodies, researchers have examined NAD+ precursors instead. NAD+ precursors already exist in the staple diet today as vitamin B3.  

However, most of the available vitamin B3 comes in the form of niacin. Niacin has been around for some time, but its unsightly symptom of skin flushing challenged researchers to look elsewhere.  

Nicotinamide riboside is favored because it's absent of these skin flushing effects, but it also raises NAD+ more efficiently than other vitamin B3s.  

Nicotinamide riboside (NR) fights the effects of damaging free radicals.  

Your mitochondria aren't perfect mechanisms. During their energy-making process, mitochondria produce byproducts—free radicals.  

Free radicals can wreak havoc on your cells, damaging essential cell functions.  

In standard settings, your body naturally produces enough antioxidants to combat these free radicals. However, certain situations of metabolic stress can tip the scales.  

Lifestyle behaviors such as poor diet, drinking, sedentary behavior, sleep deprivation, and long-term sun exposure can all lead to an imbalance between your free radicals and antioxidants.  

How does this happen? Your body requires significant energy resources to combat and recover from these activities, so your mitochondria kick into overdrive to provide the energy and offset the sudden demand.  

By boosting NAD+, nicotinamide riboside can help limit free radical damage.  

Nicotinamide riboside (NR) promotes cell repair.  

Nicotinamide riboside activates sirtuin activity in the cell. Sirtuins are a class of enzymes in the body responsible for gene regulation, the systemic process of turning certain parts of your genetic code on and off.   

Why is this system important? Turning off specific genes, aka "silencing," is critical to regulating the cell, maintaining its shape and health for optimal function.   

But sirtuins play a critical role in cell repair as well. A review published in the Current Opinion in Genetics & Development states, 

“In the past decade, the roles of sirtuins in maintaining genomic stability have been described, as regulators of DNA repair pathways, chromatin structure, and telomere maintenance.” 

Like the mitochondrial enzymes, sirtuins cannot operate without the help of the coenzyme NAD+. And nicotinamide riboside helps boost NAD+, activating cell repair in effect.  

Nicotinamide riboside (NR) supports heart health.  

Your heart is one of the most critical organs in your body, requiring loads of energy to sustain your heartbeat.   

Being one of the most energy-expensive functions in the body, thousands of mitochondria churn out energy in your heart cells.    

However, your heart's physiology can change with age. Your valves can become stiff, your heart walls can grow thick, and your heart's mitochondria can become less efficient.  

A review from Circulation Research shows that your mitochondrial count in cardiac cells declines as you age. Fewer mitochondria leave less help to divide the work—the labor of generating energy for your heart cells.  

In combination with a healthy diet and exercise lifestyle, nicotinamide riboside supports your heart health by supporting your mitochondria.   

Nicotinamide riboside (NR) helps support healthy muscles.  

When you think about how nicotinamide riboside fuels your body's cellular energy, the first thing you might wonder is how it affects your workout.  

Like the heart, your muscle cells require thousands of mitochondria because of their unique energy demand. And where there are mitochondria, there needs to be an abundant amount of NAD+.   

A review published in Skeletal Muscle notes the need for NAD+ in muscle development. The abstract states,  

"The vast majority of studies indicate that lower NAD+ levels are deleterious for muscle health and higher NAD+ levels augment muscle health."  

But muscle function isn't all about energy and its expense. Every workout needs a recovery period, and with it comes sore muscles and a bag of ice. How does NAD+ play a role post-exercise?  

According to a review published in the International Journal of Molecular Sciences, the NAD-dependent enzymes, sirtuins, play a critical role in muscle repair. In response to exercise, sirtuins activate two functions that enable the body to be more readily prepared for your next workout: (1) mitochondrial biogenesis and (2) oxidative capacity.    

• (1) Mitochondrial biogenesis is a process where the body creates more mitochondria. With more mitochondria, the body is more readily capable of supporting the increase in energy demand that comes with exercise.   

• (2) Oxidative capacity is a measure of a muscle's maximal capacity to use oxygen. With higher oxidative capacity, the muscle can exert greater efficiency. 

Nicotinamide riboside is the most efficient way to boost NAD+, best serving these NAD-dependent mechanisms in muscle cells.  

Nicotinamide riboside (NR) promotes healthy aging.  

"Anti-aging" is a marketing gimmick. There are no products out there that can effectively reverse the aging process. Instead, the World Health Organization (WHO) is focused on promoting the idea of healthy aging.   

The WHO defines healthy aging as "the process of developing and maintaining the functional ability that enables wellbeing in older age."   

Healthy aging is about maximizing your lifetime to its fullest potential, retaining your independence and mobility.   

Nicotinamide riboside is classified as a healthy aging supplement because of its unique ability to support health on a cellular level at any age. By targeting the maintenance of cells, NR helps your cells sustain their resilience to aging.   

Although being called the "anti-aging" pill is more of a misnomer, nicotinamide riboside's unique role in countering everyday wear and tear directly contributes to anyone's desire to age gracefully.