As I paged through the second edition of Dan Buettner's "The Blue Zones," pondering the benefits of goat's milk, beans, garden vegetables and the like, I suddenly noticed a sentence with the word "cookies" in it! His personal interviews with the centenarians from the Sardinian mountain regions were most revealing and interesting. Before heading off to visit the family mountaintop pasture, Dan "downed a dozen cookies with a few glasses of wine" with Tonino, the 75-year-old son of a centenarian. It turns out that "papassini," Sardinian cookies made with raisins, almonds, and jam from cooked red wine (saba), are very popular, especially at festivals and during holiday seasons. So right before Thanksgiving and the Christmas/New Year season, I learn that cookies may be okay after all! The recipe for papassini includes almonds (or walnuts), golden raisins, flour, eggs, vanilla powder, vegetable shortening, plus whole milk.

So do Sardinians live a long life despite eating cookies or are cookies actually part of the magic formula for life beyond 100 years?  Maybe, if they didn't eat cookies they could live to be 150 years? At this point, I am thinking that 100 years seem fine.  But, as I focused in on the individual stories of centenarians from "The Blue Zones" in Sardinia, Okinawa, California, Costa Rica, and the island of Ikaria in Greece, I appreciated the great diversity in factors contributing to long life. With regard to food, there are both similarities and differences. The major common feature is reliance upon a lean, plant-based diet. Herbal and medicinal teas are common. Red wine (Cannonau or Grenache) high in flavonoids is popular in Sardinia and Ikaria.  Fresh goat's milk and grass-fed sheep cheeses are also popular in both these blue zones. The high omega-3 fatty acids in these products may be especially important since fish is eaten, but is not a consistent staple across the blue zones.  There is liberal use of olive oil as well as frequent use of pork lard in cooking.  Of note, eggs often accompany beans, rice, and tortillas. Breads are whole grain.  Both sweet and traditional potatoes are used.  Meat-eating is definitely low, and is restricted mainly to pork, with less frequent beef reserved for holidays and festivals.

But it turns out that many key features of blue zones are not food related.  It is important to realize that "The Blue Zones" are not idyllic paradises with individuals focused on their "best diet."  These centenarians, by and large, have endured many hardships in their lives and eaten what is available: often not enough.  Even when they have enough food in Okinawa, the centenarians stop eating when they are 80% full.  These are tough, decisive people doing their best to survive. There is an underlying faith that "God will provide" despite precarious circumstances. There is freedom from the financial and social pressures of modern society.  Elders are revered within the family and community. These are not "me" societies: it is all about the extended family. Time and deadlines are not important. Naps are okay and part of the pattern of life.

Dan Buettner and his diverse collection of experts have tried very hard to sort out the dietary, genetic, and social factors that can lead to long life. In Costa Rica, the centenarians are closely linked to the Chorotega Indians, but there may still be genetic diversity and strength from what locals call "mixed blood" in this blue zone.  Ultimately, the causes of longevity are clearly multifactorial.

And so, I came back to my starting question: what about the cookies? As I turned to page 238, I spotted another sentence with cookies in it: this time anisette cookies.  It turns out that, in Ikaria, they also love cookies, in this case, anisette cookies, which are remarkably similar to "papassini," using almond extract instead of crushed almonds.

So my final take-away is to rely on what Dan Buettner's team calls "Vitamin S" as a magic ingredient.  In this case, S is for Smile! Centenarians and the rest of us, if we want to be like them, need to be happy, sociable, welcoming people always ready with a smile. If that smile, from time to time, combines with cookies and red wine, this can be a good thing!

Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.

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