Embracing the Blue Zones Part Three: Food & Nutrition in Ikaria

As many health care professionals are aware, our lifestyle choices can have a huge impact on our healthy aging journey. Diet and nutrition play a major role in our overall health and well-being, and diet is a huge factor in the five Blue Zones around the globe.

As I mentioned in Part Two of this series, I did not observe one obese man, woman, or child during my week traveling around the island of Ikaria. As of a 2023 report (CDC, 2023), obesity affects two in five adults and one in six children in the United States. Not surprisingly, and according to the CDC, the top factors impacting obesity in the United States include a lack of physical activity, unhealthy eating habits, highly processed foods or added sugars, not enough fruits and vegetables, not enough or poor quality of sleep, excess TV, computer, video games, and other screen time. It is clear from my travels around Ikaria and Sardinia, as well as the research I conducted for this Blue Zone journey, the same factors are not an issue in these longevity hubs.

It is also really important to remember that not all inhabitants of Sardinia and Ikaria live in the main Blue Zone villages and practice the lifestyle related to longevity. These villages tend to be exceedingly small and isolated from the larger towns and villages scattered throughout both islands, especially on Sardinia which is the second largest island in the Mediterranean, with many large cities and tourist hubs. I traveled through several treacherous one-lane mountain roads to reach many of these small, isolated Blue Zone villages. In one conversation with a woman in Ikaria, she stated, “Most of us do not live the way the centenarians lived in previous years. We now have markets and other services that make life much easier than it was years ago. We do not all have our own gardens, sheep, and goats.”

As health care professionals and busy leaders, each of us deals with high levels of stress on a daily basis. Research has proven that long-term stress can affect your brain and trigger your body to increase certain hormones, such as cortisol. These hormones regulate energy balances and hunger urges that often increase appetite and promote cravings for unhealthy foods (Mayo Clinic, 2024). Throughout my career, I often treated my stress with unhealthy dietary practices. Like many of you, I also traveled extensively for business and often used this an excuse for my unhealthy dining choices when out in restaurants or ordering from the plethora of fast food delivery services now available throughout the United States.

Following my retirement from my full-time executive position last September, I decided to get serious about trying to create a healthy balance in my life. In all honesty, I had completely lost sight of a work-life balance. The long hours, travel, and stress of my work life had created unhealthy dietary practices that resulted in significant weight gain and cardiovascular issues, which highlights one of the main consequences of an unhealthy diet filled with fat, prepared foods, and the chemical additives often prevalent in our American diets.

I was fortunate to find an amazing physician-supervised weight loss program and major support from my cardiologist and internist that has resulted in a 70-pound weight loss over the past year. Although I knew nothing about Blue Zone eating habits last year, my three physicians had me following a Mediterranean diet high in fruits and vegetables and low in fatty or red meats. The diet did allow fish, seafood, and lean white meats.

Following my weight loss, my cardiologist and internist have now discontinued all four of my prescription medications, my “bad cholesterol" (LDL) has dropped from 170 to 70, my BP dropped from about 200/100 to 110/70, and my cardiac calcium score is now zero. I saw my cardiologist prior to this Blue Zone journey, and he stated that I have restored my cardiac health to that of a 35-year-old, and I am now 63. I have not only enjoyed an improved state of physical and cardiovascular health, but a huge improvement in my psychological well-being and reduced stress levels.

After visiting the first three Blue Zones, I now have a much better handle on what we can do to improve our overall health and well-being through lifestyle practices, exercise, diet, and nutrition. I observed several elderly adults (some with simple walking sticks and groceries) walking the steep village and mountain roads, and there is no way I could have kept up with any of them. Although I have never smoked and did not witness inhabitants of Ikaria smoking or vaping in the small villages I visited, literature indicates that many people on Ikaria do smoke in moderation. Despite this, there are low levels of lung cancer reported, likely due to the Ikarian lifestyle (Purdue University, 2021). As mentioned in my previous posts, Alzheimer’s disease and other forms of dementia are almost non-existent, and one in three Ikarians live to be over 90 years of age (Blue Zones, 2024). I visited a small mountain top cemetery while in Ikaria, and many of the gravesites contained adults well over the age of 90, and some over 100.

The following content highlights some of the key findings of my personal journey to the small Blue Zone villages of Ikaria. Compared to our American diet, there is little consumption of sugar, white flour, and low consumption of red meat or fish in Ikaria. A typical breakfast is NOT bacon and eggs, with toast with butter. Instead, a typical breakfast consumed in Ikaria is a spoonful of olive oil or honey, whole grains, or rusks (dried bread), goat’s milk, cheese made from goat’s milk, and olives or fresh fruits or vegetables. For the first time in my life, I enjoyed fresh olives and fresh raw tomatoes every morning while I was in Ikaria and Sardinia. I was also happy to read (and hear directly from those I spoke to in Ikaria), that daily “napping” and rest are deeply engrained in the Ikarian culture.

While driving around the island I discovered only one main hospital in Agios Kirykos (General Prefectorial Hospital) and very few pharmacies and health care clinics in the small villages. The expansive variety of healthcare services we are privileged to access in the United States are clearly not available on the island of Ikaria.

My Personal Observations: Key Elements of Diet and Nutrition in Ikaria

1.????? An Abundance of Fresh Fruits and Vegetables

Each of the small markets and specialty stores I visited had an abundance of beautiful, fresh, local produce. Many inhabitants have their own personal gardens, and unlike the US, chemicals and pesticides are not used in the growth of fruits and vegetables. The stores and small, local?restaurants I visited also sold a variety of dried fruits, including figs and raisins, and naturally prepared fruit juices.

Many menus included potatoes, but they were not “double-baked” and filled with bacon, cheese, and sour cream. Fresh potatoes were simply prepared and often served sliced, with olive oil, goat cheese, garlic, and herbs. Breakfast often included fresh or grilled tomatoes and mushrooms simply prepared in olive oil. Leafy greens are abundant and include spinach, kale, beet and turnip tops, chard, and collards. To enhance your health, many of these leafy greens can be included in your fruit smoothies to add additional nutritive content.

If you read about Dan Buettner, the now-famous National Geographic Fellow and Co-producer of “Live to 100: Secrets of the Blue Zones,” he eats an amazing vegetable soup for breakfast each morning and shares his soup recipe on his Blue Zone website (Dan Buettner.com , 2024).?

2.????? Olives and Olive Oil

Olives have been a staple in the Greek diet throughout history. Olive oil is not only used for cooking, some Ikarians ingest a spoonful of olive oil each morning. Olive oil was also drizzled over many of the appetizers and main dishes I ordered in restaurants. Every breakfast I consumed in both Sardinia and Ikaria had a variety of fresh olives served at breakfast, and they are also added to many salads. I enjoyed an abundance of different varieties of green and black olives throughout my travels in Ikaria and Sardinia, and olive trees are scattered throughout these islands.

3.????? Whole Grains and Locally Grown Legumes and Beans

The abundance of legumes and beans assists with protein intake and the low level of meat consumption in Ikaria, and most of their dietary protein comes from this group. Seminal components of this diet include fava beans, lentils, chickpeas, gigantes, and split peas. I enjoyed a mashed fava bean dip that was simply prepared, drizzled with olive oil, and similar to the texture of hummus. One gentleman told me that his family favorite for special occasions is fresh octopus served over mashed fava beans.

4.????? Natural Herbs and Herbal Teas Foraged from the Island

Ikaria has several naturally grown and hand-picked herbal teas loaded with antioxidants, antibacterial properties, and nutrients. Varieties include Greek sage, rosemary, and dandelion tea that can be enjoyed throughout the day. The one small airport in Ikaria had many varieties of tea for sale in the small gift shop. I often ordered the tea after a meal or with an afternoon snack while traveling in Ikaria and other islands in Greece. Freshly grown herbs are often included in salads and main dishes. I made a delicious Greek watermelon and feta salad last night with a recipe I received on my trip, and it contained fresh dill, parsley, and mint. I visited three different specialty grocery stores in Sarasota before I found these fresh herbs available in the produce department.

5.????? Nuts and Grains

I have several photos of markets and restaurants in both Ikaria and Sardinia that had bins of different types of nuts and grains. Faro, bulgur, whole wheat, or chickpea/lentil pasta were common on menus. There is little use of processed white flour on the island. Common varieties of nuts included almonds, pistachios, walnuts, sesame seeds, and tahini which is a thick, smooth oily paste made from sesame seeds. Breakfasts are often served as buffets in the small hotels, and most also include a variety of different grains and nuts. Prior to this Blue Zone journey, I was always too fearful of fat and calorie content to include nuts in my diet, and I now realize the health benefits of consuming small amounts on a daily basis.

6.????? Raw Unfiltered Honey

Unlike Americans, the inhabitants of Ikaria do not consume processed white sugar or artificial sweeteners. Similar to olive oil, daily intake of this healing precious gold liquid is one of the key secrets of longevity on Ikaria and Sardinia. Natural honey assists with regulation of blood sugar levels and I was told that many people ingest a spoonful of honey each morning. For the past year I have been adding a teaspoon of Manuka honey from New Zealand and non-fat Greek yogurt to my morning fruit smoothie.

Ikarian honey has anti-cancer, anti-inflammatory, antibacterial and antioxidant properties that promote healing. I visited a specialty store in Ikaria and the owner brought me through an amazing “honey tasting journey” with locally produced honeys. This honey tastes nothing like the store-bought processed versions that we often consume in the US, which are often devoid of any nutritional benefit due to the processing that occurs.

Ikarian honey is naturally created with no filtration, heat, or pasteurization which often destroys natural vitamin and mineral content. As an interesting side note, the daily breakfast buffets I enjoyed in Sardinia, Athens, and the island of Crete had entire honeycomb frames directly from the beekeepers’ hives available for guests to enjoy at breakfast. I now have a Greek olive wood honey pot and dipper containing unfiltered Ikarian honey on my kitchen counter.

If you want to try an amazing and delicious healthy dressing, whisk together the following ingredients until the olive oil is emulsified and serve as a dressing:

????????????? 2 TBLSP Red Wine Vinegar

????????????? 2 TBLSP Freshly Squeezed Lemon Juice

????????????? 2 TSP Honey

????????????? 2 Minced Garlic Cloves

????????????? ? TSP Dried Dill

????????????? Kosher Salt and Pepper to Taste

????????????? ? Cup Good Quality Olive Oil

7.????? Yogurt

This is NOT your average Dannon or Yoplait American yogurt! Traditional Greek yogurt in Ikaria is produced with goats’ milk and has a rich creamy texture with a very sour flavor. To me, it tastes like a rich and fresh sour cream. It was remarkably similar to the “Filia” my Finnish father used to make by allowing whole milk to sour in a jar in the refrigerator when I was a child. Many cafes and tavernas I visited served fresh Greek yogurt parfaits with fresh fruit and grains. Their natural yogurts are also rich in probiotics which produce gut health. The fresh tzatziki in Ikaria was amazing and simple: Greek yogurt, virgin olive oil, garlic, fresh cucumber, fresh dill, and other herbs. If you want to make a healthy low-fat version at home, you can also use non-fat traditional Greek yogurt. I often use this as a vegetable or meat dip or serve it with fresh whole-grain grilled pita slices and grilled chicken breast or shrimp.

8.????? Cheese

Every small market I visited had a large, refrigerated section with a variety of beautiful and fragrant cheeses. Although I often use Feta cheese for salads, I was unaware that there were different textures of these goat cheeses other than the crumbly version we often buy in the US. Feta cheese is abundant and often used as an ingredient in salads, pasta, and other main dishes. My favorite dish in Ikaria (I ordered it three times) was large, fresh, whole prawns from the sea that were simply baked in a fresh tomato sauce with small chunks of feta cheese. It was delicious, low calorie, and healthy! As previously mentioned, all of the breakfasts I enjoyed in Sardinia, Ikaria, and other areas of Greece also included a variety of fresh cheeses. Rather than producing their cheeses from cow’s milk, most are produced from sheep or goat’s milk, and the taste and texture are amazing!

9.????? Wine

When studying current information available on the Blue Zones, centenarians also indicate that wine is one of the most basic elements of Ikarian nutrition. I was told that they often drink 2-3 glasses per day, and often as a “snack” shared with friends and family. They are pure and natural terroir wines rich in minerals. The wine is unfiltered and contains levels of artery-scrubbing flavonoids and other healthy ingredients that may impact cardiovascular health in this population of centenarians. The wine is also said to increase absorption of antioxidants while lowering blood pressure.

The red wine in Ikaria tastes similar to the strong flavors of the Cannonau wine popular in Sardinia. I tried a variety of red, rosé, and white wines produced on the island, and they were all incredible. I am unable to drink most domestic and California wines due to a severe reaction to sulfites and other commonly used chemicals. The wine in Sardinia and Ikaria never left me with the typical nausea or heavy feeling I often experience after consuming American varietals. This was despite the fact that many of their wines have a high alcohol content of 14-18%. I finished this trip enjoying the Greek island of Crete, and the wines were equally delicious! I toured two different wineries, and the production of these wines is natural, and vastly different than the mass production we often see in the United States. The grapes are often crushed in granite vats and fermented in clay amphora (pitharia).

The wines I reviewed and tasted on Sardinia and Ikaria were very inexpensive, often only 4-12 Euros per glass on most menus. Many bottles of high-quality wine in Ikaria were under 15 Euros per bottle.

What They Do Not Overeat in Ikaria

Although I did see farm fresh eggs in the markets, people in Ikaria often only consume them 2-4 times a week, and often as a side dish to a whole grain or plant-based main menu item. When driving through the mountainside villages, I often saw goat pens perched on the steep mountain roads that also had chickens in the pen.

Although there was a variety of meat, sausage, seafood, and fish in the markets and on most menus, most Ikarians do not eat daily meat, and red meat is consumed only a few times per month. I grew up with a father from Finland who was a professional meat cutter (butcher), and he brought home red meat daily and liver weekly, and told his four daughters, “I want you to grow up to be strong and healthy American women.” Rarely did I see beef on a menu in Ikaria, and although I saw many goats and sheep, I did not find cattle in any of the villages I traveled through. Typical meat includes pigs, goats, chicken, and fish or seafood straight from the sea. According to recent literature, the diet consumed by Centenarians in Ikaria for most of their lives contained about 6% fish and 5% meat compared to 20% vegetables, 17% greens, 16% fruits, and 11% legumes.

Unlike consumption of our cow’s milk in the U.S., Ikarians use grass-fed goat milk. This contains ample potassium plus the added benefit of the stress-relieving hormone L-Tryptophan. Unknown to me, it is also hypoallergenic and usually well-tolerated by those who are lactose intolerant. I saw more sheep and goats on hills and steep mountains in Greece than I have observed anywhere else on my global travels!

When I was visiting Ikaria, they were experiencing major issues with swarming bees in the outdoor cafes, tavernas, and restaurants. In three different restaurants the server brought a metal plate to my table containing a heap of freshly ground Ikarian coffee. They ignited the coffee and the smoke immediately cleared the bees that were swarming my table and food. It was amazing to see this natural non-pesticide repellant in action, and the aroma was fabulous!

In closing, I must repeat that this has been a life-changing journey. Although I was previously following a healthy Mediterranean diet, this trip through Sardinia and Ikaria has really solidified the relationship between food and physical/emotional well-being. I am returning home with many new and important health strategies due to the amazing lessons from the centenarians and longevity experts in these cultures who are practicing the keys to longevity and healthy aging. Thanks for joining me on this journey. Next up: Insights from Okinawa and Nicoya! Wishing you good health, as well as contentment, and a fulfilled and purpose-driven aging journey.

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Abbreviated Source Summary

1.????????????????? www.CDC.gov >data-research, 2024, Adult Obesity Facts.

2.????????????????? www.mayoclinic.org , 2024, Chronic Stress Puts Your Health At Risk.

3.????????????????? www.purdue.edu , 2024, Ikaria Cultural Immersion Experience – How to Age Successfully.

4.????????????????? www.bluezones.com , 2024, A Greek Island’s Ancient Secret to Avoiding Alzheimer’s.

5.????????????????? www.danbuettner.com , 2024, Blue Zones Minestrone-Dan’s Version.