The Sixth Blue Zone

PREMIUM CONTENT for MEMBERS ONLY

Please login to view this content , or sign up for an account

Dan Buettner, an award-winning journalist, National Geographic Fellow, and New York Times bestselling author, and founder of the Blue Zones LLC, is best known for his Blue Zones concept. The original five blue zones he identified include Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; and Loma Linda, California. These five blue zones all have the same major underlying theme: healthy and happy populations with increased longevity, including a high number of centenarians (individuals living 100 years or more). While few places around the world qualify as a blue zone, Buettner has recently found one more to add to the list.

As he traveled the world in search for another location that would meet the criteria of a blue zone, he was able to add Singapore to the list. In addition to the lively Singaporean communities he encountered, he recognized it as a place of health and happiness based on the city state’s health metrics, policies, and ecosystem. The health data from Singapore demonstrate that the number of centenarians have doubled over the last decade, plus the life expectancy has grown by 20 years since 1960. When compared with corresponding statistics from the US, it appears that people in Singapore live longer and healthier lives.

Since 1960, the largest gains in life expectancy occurred between 1970 and 1980—an increase of about three years from 70.8 to 73.7 years. The current life expectancy for the U.S. in 2023 is 79.1 years, a 0.08% increase from 2022, following a similar small increase from one year earlier. There were 89,739 centenarians living in the United States in 2021, nearly twice as many as there were 20 years ago.

One particular individual that Buettner met during his travels to Singapore specifically stood out to him. In his quest to find the happiest and healthiest populations in the world, Buettner encountered Douglas Foo, a 60-year-old man and self-made millionaire who began the food chain Sakae Sushi in Singapore. It wasn’t his career accomplishments that stood out to Buettner, but his energetic spirit and positive outlook on life. Buettner highlights Foo’s drive, commitment to his family, dedication to his community, and contagious enthusiasm. Residents like Foo stood out to Buettner as examples of individuals who living happy and healthy lives in forward thinking communities.

Singapore has long been renowned as a lucrative financial hub, but its government policies shaped this financial boom it into an evolving health landscape. In Buettner’s new book, “The Blue Zones: Secrets for Living Longer,” he refers to Singapore as “the blue zone 2.0.” Singapore is unique to the five other original blue zones and is now being recognized for having the longest and healthiest population with a very high life satisfaction rate.

“Singapore has long been renowned as a lucrative financial hub, but its government policies shaped this financial boom into an evolving health landscape.”

While the five original blue zones’ health metrics originate from a rich history, cultural backgrounds, and traditions, Singapore’s health metrics stem from new changes made over time. Singapore has been implementing policies that have evolved their population to stay engaged by daily movement, interconnectedness, and consuming a healthy diet.

The government policies put in place are now incentivizing individuals to shop for healthy food options. Residents are not only encouraged but subsidized to select whole foods with quality nutrients. This policy has limited the intake of ultra-processed foods, leading to more positive health outcomes. Government policies enforced reductions in the amount of sugar being added to drinks resulting in residents consuming less sugar. Additionally, food items with low amounts of sugar are specifically labeled as healthy foods.

Singapore also recognizes the positive impact of a physically active society. The residents are motivated to opt for walking as their mode of transportation due to pedestrians being favored over motorists. Walking has become the best option, as taxes have increased on cars and gasoline. Walkable public transit stations have been put into place, making them accessible to all and the more environmentally friendly option.

“Beyond the environmental benefits, walking has also provided a way for residents to foster connections with other residents on the walkways.”

Walkable cities such as New York City may keep its residents active, but the hustle and chaos surrounding the streets can actually impose stress on the active individual. Walking in nature can cause a significant decrease in negative thoughts and emotions compared to an urban environment. Singapore understands the profound effects nature has on our thoughts, so they have successfully implemented elements of nature into their urban environment. Walkways are designed with intentional green space to increase connection to nature and urban developers have found ways to weave biodiverse gardens and plant life all throughout the city. A unique example of blending natural spaces with high rise structures and intense traffic are the Singapore Gardens by the Bay. Beyond the environmental benefits, walking has also provided a way for residents to foster connections with other residents on the walkways.

Interconnectedness is an often overlooked component necessary for a healthy life. Singapore has created an environment designed to combat loneliness and increase a sense of community. The high-rise buildings and communal spaces have made Singapore an interactive environment. It is the social norm to congregate in shared spaces and foster a relationship, old or new, with the person next to you.

“Singapore has created an environment designed to combat loneliness and increase a sense of community.”

Our modern world has created a loneliness epidemic and having a strong social or emotional support system has significant implications on our wellbeing. Social support has a profound impact on our physical health and wellbeing. Going beyond creating an interconnected society, Singapore also offers their residents a tax break if their aging parents live close by or with them. This policy encourages families to stay connected with one another. Singapore aims to connect the elderly population with all generations and celebrate them as a source of wisdom and knowledge.

Singapore showcases the responsibility of government and policy makers when it comes to the health of our global communities. With environments and societies that promote toxic eating habits and a sedentary lifestyle, it becomes an uphill battle for individuals to make healthy choices. It is time that the responsibility shifts away from being solely on the individual, and systemic changes are made.

“With environments and societies that promote toxic eating habits and a sedentary lifestyle, it becomes an uphill battle for individuals to make healthy choices.”

While Buettner states that discovering another “organic blue zone” like the original five zones would be hard to come by, he hopes to find another “blue zone 2.0” in the future. As other areas begin to adopt similar government policies like Singapore, they too can aspire to have thriving, healthy populations with increased longevity.

However, we are left with the intriguing question of the rapidly rising population of centenarians outside of the Blue zones in different parts of the world, such as Italy, Japan, and South Korea. Is it the widespread use of medications to treat hypertension, and metabolic disorders such as diabetes and hyperlipidemia that is underlying this trend? Will the anticipated widespread use of GLP-1 and GIP agonists like Ozempic and Tirzepatide which have shown in earlier trials to reduce the risk of metabolic and cardiovascular diseases further accelerate the increase in centenarians? And if yes, wouldn’t it be most interesting to study the places in the world that reach hundred years of age without these expensive medications?

Emeran Mayer, MD is a Distinguished Research Professor in the Departments of Medicine, Physiology and Psychiatry at the David Geffen School of Medicine at UCLA, the Executive Director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience and the Founding Director of the Goodman-Luskin Microbiome Center at UCLA.