Blue Zones uncovered: a physician’s first-hand experience


A windy, bumpy road led my family into Costa Rica’s remote Nicoya Peninsula, one of the world’s five so-called Blue Zones. Our arrival in 2021 satisfied a wish I had made while undergoing chemotherapy for breast cancer to visit this fascinating, biodiverse region where people are documented to live healthier, longer lives.

I have taught my students in the lifestyle medicine program at Metropolitan State University in Denver about the literature and evidence supporting lifestyle behaviors specific to Blue Zones for years. But to travel there, meet the people and observe their lives was remarkable. I watched people in their 80s ascend steep hills to the terrace gardens where they harvest their food. A man in his 90s on horseback gave us directions when we got lost. Beans were plentiful in meals. The residents were purposeful and committed to family and friends. Time moved slowly there, and I have returned several times.

These experiences are one reason I am excited that lifestyle medicine-certified physicians and health professionals will soon have the exclusive opportunity to pursue a “Blue Zone certification” status. As a lifestyle medicine-certified clinician, I see the opportunity to connect the Blue Zones community resources and infrastructure with the whole-person care that lifestyle medicine clinicians have provided inside clinics as an opportunity-rich with promise.

We all know our current model of health care isn’t working—not for patients or physicians. We spend more on health care than other high-income countries and get worse outcomes. About 60 percent of adults have at least one chronic disease and the vast majority of those conditions are lifestyle related. Physician burnout is causing some doctors to leave the field. A growing number of physicians have turned to lifestyle medicine to reignite their passion for healing and improve their own health.

Lifestyle medicine-certified clinicians are trained to apply evidence-based, whole-person, prescriptive lifestyle change to treat and, when used intensively, often reverse conditions, such as cardiovascular diseases, type 2 diabetes, and obesity. Applying the six pillars of lifestyle medicine—a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, positive social connections, and avoidance of risky substances—also provides effective prevention for these conditions. Since certification began in 2017, almost 6,700 clinicians worldwide have become certified to practice lifestyle medicine.

The crossover between the pillars of lifestyle medicine and the lifestyle habits identified in Blue Zones–known as the Power 9®—are significant. Lifestyle medicine clinicians can incorporate aspects of Blue Zones, such as finding purpose and happiness, as well as learn how to better support patients’ lifestyle behaviors in their home, work, or community environments. This will expand a clinician’s toolbox in a way that helps patients understand that lifestyle medicine is not just something that happens inside a doctor’s office but through all the daily behavior habits that happen where they live, work, and play.

Blue Zones’ strong name recognition is an opportunity for clinicians. Many people who are not yet familiar with the growing field of lifestyle medicine will recognize Blue Zones, maybe from restaurants, schools, and organizations in their own communities or the popular recent Netflix series “Live to 100: Secrets of the Blue Zones.” Blue Zones certification status will help physicians and other health professionals stand out immediately as clinicians with the training and skills to help patients make sustainable lifestyle behavior changes to prevent, treat, and reverse disease.

Many of the lifestyle medicine clinicians I know strongly desire to be leaders in their community. They have seen evidence of health improvements as a result of treating the root causes of disease rather than only the symptoms with growing quantities of pharmaceuticals and procedures. Blue Zones training will help provide the tools and mindset for clinicians to amplify their impact beyond the clinic walls and into their community, positioning them to become real changemakers.

Michelle Tollefson is a lifestyle medicine, obstetrics, and gynecology physician.


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