The Nicoya region of Costa Rica: a high longevity island for elderly males

Rosero-Bixby, Luis; Dow, William H.; Rehkopf, David H.

doi:10.1553/populationyearbook2013s109

Cited by 44 publications

(38 citation statements)

References 29 publications

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“…In addition, regimes implying moderate or low intake of animal proteins have been described in other longevity areas such as Loma Linda (USA), 43 which favors a vegetarian diet, Okinawa, 44 Ikaria 45 and Nicoya. 46 We found that among Sardinian highlanders, the generations that were in their old age during NT experienced an increased capability for the acquisition of animal proteins, which might have contributed to delaying the onset of sarcopenia and osteopenia. 47 These findings are consistent with the results of NHANES III study recently reported by Levine et al 48 showing that higher protein intake is associated with significantly increased risks of mortality only among people aged 50-65 years, whereas this effect is no longer observed among adults over the age of 65 years.…”

Section: Nutritional Differences In Sardinia According To the Traditimentioning

confidence: 75%

Male longevity in Sardinia, a review of historical sources supporting a causal link with dietary factors

et al. 2014

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The identification of a hot spot of exceptional longevity, the Longevity Blue Zone (LBZ), in the mountain population of Sardinia has aroused considerable interest toward its traditional food as one of the potential causal factors. This preliminary study on the traditional Sardinian diet has been supported by the literature available, which has been carefully reviewed and compared. Up to a short time ago, the LBZ population depended mostly upon livestock rearing, and consumption of animal-derived foods was relatively higher than in the rest of the island. The nutrition transition (NT) in urbanized and lowland areas began in the mid-1950s, fueled by economic development, whereas in the LBZ it started later owing to prolonged resistance to change by a society organized around a rather efficient pastoral economy. Even nowadays a large proportion of the population in this area still follows the traditional diet based on cereal-derived foods and dairy products. The LBZ cohorts comprising individuals who were of a mature age when NT began may have benefited both from the high-quality, albeit rather monotonous, traditional diet to which they had been exposed most of their life and from the transitional diet, which introduced positive changes such as more variety, increased consumption of fruits and vegetables and moderate meat intake. It could be speculated that these changes may have brought substantial health benefits to this particular aging group, which was in need of nutrient-rich food at this specific time in life, thereby resulting in a decreased mortality risk and, in turn, life-span extension.

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Section: Nutritional Differences In Sardinia According To the Traditimentioning

confidence: 75%

Male longevity in Sardinia, a review of historical sources supporting a causal link with dietary factors

et al. 2014

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“…The data used in this article for Costa Rica should be virtually free of those limitations because (i) age was established from the date of birth in the national registry and (ii) the followup of deaths double checked survival with independent sources: the voting lists in the NLMS and household visits in the CRELES (40,41). Two limitations in the databases used in this article are (i) the exclusion of institutionalized individuals in the US samples, which would slightly underestimate US mortality, and (ii) the exclusion of foreigners (about 4% of the population) in the Costa Rica follow-up, which might slightly overestimate mortality if we believe that immigrants are a select group with better than average health (42).…”

Section: Discussionmentioning

confidence: 99%

Exploring why Costa Rica outperforms the United States in life expectancy: A tale of two inequality gradients

Rosero-Bixby

Dow

2016

Proc. Natl. Acad. Sci. U.S.A.

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Mortality in the United States is 18% higher than in Costa Rica among adult men and 10% higher among middle-aged women, despite the several times higher income and health expenditures of the United States. This comparison simultaneously shows the potential for substantially lowering mortality in other middleincome countries and highlights the United States' poor health performance. The United States' underperformance is strongly linked to its much steeper socioeconomic (SES) gradients in health. Although the highest SES quartile in the United States has better mortality than the highest quartile in Costa Rica, US mortality in its lowest quartile is markedly worse than in Costa Rica's lowest quartile, providing powerful evidence that the US health inequality patterns are not inevitable. High SES-mortality gradients in the United States are apparent in all broad cause-of-death groups, but Costa Rica's overall mortality advantage can be explained largely by two causes of death: lung cancer and heart disease. Lung cancer mortality in the United States is four times higher among men and six times higher among women compared with Costa Rica. Mortality by heart disease is 54% and 12% higher in the United States than in Costa Rica for men and women, respectively. SES gradients for heart disease and diabetes mortality are also much steeper in the United States. These patterns may be partly explained by much steeper SES gradients in the United States compared with Costa Rica for behavioral and medical risk factors such as smoking, obesity, lack of health insurance, and uncontrolled dysglycemia and hypertension.adult mortality | socioeconomic status | inequality |

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“…Comparison between studies are complicated by different outcome measures and especially different study periods, but the relative increase in probability of becoming a centenarian of 37% can be compared to the 50% increase in probability for the Sardinian blue zone or the three-fold increase in probability for the Sardinian restricted blue zone [1]. Similarly, the age 70-100 death rate ratio of 0.95 for the Langeland hotspot compares to the death rate ratio of 0.8 for Nicoyan men [5]. Given the relatively high geographic, economic and cultural homogeneity in Denmark, it is not surprising that relative differences in centenarian proportions within Denmark are moderate.…”

Section: Discussionmentioning

confidence: 99%

“…The first of the current generation of well-validated longevity regions is the Sardinian “blue zone” [2], a small group of villages where a particularly large percentage of those born there from 1880 to 1900 become centenarians. Other “blue zones” have been identified in the Okinawa region in Japan [3], the Ikaria Island in Greece [4] and the Nicoya peninsula in Costa Rica [5]. …”

Section: Introductionmentioning

confidence: 99%

“…Life style factors have been investigated with varying results - the population of the Nicoya region has a diet rich in fibers, proteins and trans fats [5], while Okinawa is the only blue zone to have a significantly lower caloric intake than the reference population [8]. For the Nicoya blue zone, it has been observed that the effect is exclusive to those born and resident in the Nicoya region, with a non-significant decrease in mortality among immigrants and no decrease in mortality among out-migrants [5]. This hints at the effect being, in some way, one of physical environment, or at least not tied to cultural factors carried along by out-migrants.…”

Section: Introductionmentioning

confidence: 99%

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Searching for longevity hotspots in Denmark

Hansen

Mortensen

Westendorp

2018

Aging

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While existing research on regions with high prevalence of centenarians has focused on selected candidate geographical regions, we explore the existence of hotspots in the whole of Denmark.We performed a Kulldorff spatial scan, searching for regions of birth, and of residence at age 71, where an increased percentage of the cohort born 1906-1915 became centenarians. We then compared mortality hazards for these regions to the rest of the country.We found a birth hotspot of 222 centenarians, 1.37 times more than expected, centered on a group of rural islands. Lower mortality hazards from age 71 onwards were confined to those born within the hotspot and persisted over a period of at least 30 years. At age 71, we found two residence-based hotspots of 348 respectively 238 centenarians, 1.46 and 1.44 times the expected numbers. One hotspot, located in high-income suburbs of the Danish capital, seems driven by selective in-migration of low-mortality individuals. The other hotspot seems driven by selective migration and lower morality among those born and residing in the hotspot.Thus, Danish centenarian hotspots do exist. The locations and interpretation depend on whether we look at place of birth or of residence late in life.

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The Nicoya region of Costa Rica: a high longevity island for elderly males

Cited by 44 publications

References 29 publications

Male longevity in Sardinia, a review of historical sources supporting a causal link with dietary factors

Male longevity in Sardinia, a review of historical sources supporting a causal link with dietary factors

Exploring why Costa Rica outperforms the United States in life expectancy: A tale of two inequality gradients

Searching for longevity hotspots in Denmark

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