A Diet From the World’s Longest-Lived Men: Sardinia, Italy

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For most of the past century members of the Melis family have started each day with an egg fried in lard, a piece of sourdough bread to soak up the yolk, a glass of goat’s milk, and two cups of coffee. Then the men strike off over the rocky, thistle-clumped terrain surrounding their village, Perdasdefogu, to pasture their sheep, while the women stay behind to mind the children, tend the garden, wash clothes in the river, mill grain, and bake bread.

At noon, lunch centers on a bowl of savory bean-and-vegetable minestrone soup garnished with a dollop of lard and a piece of bread washed down with a glass of deep-red Cannonau wine. An early dinner begins with leftover soup, segueing to seasonal garden vegetables, more bread, hard pecorino cheese, and, occasionally, a small piece of larded pork—again accompanied by the wine. While pork, white bread, eggs, and lard might not sound like the hallmarks of a longevity diet, it has worked for the nine brothers and sisters of the Melis family. They hold the Guinness world record for the highest combined age of any nine siblings: a total of 828 years. In August 2013, the eldest sister, Consolata, turned 106.

The Melis family lives on the Italian island of Sardinia, in the middle of the Mediterranean, almost equidistant from France, Italy, and North Africa. Here 42,000 people, descendants of a Bronze Age culture, occupy the rocky slopes of the Supramonte mountains in villages that festoon the hills like a giant string of pearls. Several thousand years ago their forebears were pushed into the rugged hills by Phoenician and Roman invaders. Unlike the landscape of coastal Sardinia, much of which is fertile farmland, these inland slopes are menacingly steep, sun-beaten, and blanketed with prickly vegetation. Nevertheless, the villages of the Ogliastra region produce more male centenarians, proportionally speaking, than anywhere else on Earth. In one village, Villagrande, not far from the Melis’ home, 5 centenarians still live among 2,500 people. In America, only 1 in about 5,000 people reaches age 100.

Not long ago I spent several weeks wandering the 14 whitewashed villages of this Blue Zone, trying to tease out details about their longevity diet. I spent three days wandering the hills with a 28-year-old shepherd who had learned his skills from his great-grandfather. Because pasturing animals over this sparse terrain required days of provisions, he had learned to travel light with foods that wouldn’t spoil. His diet: unleavened carta di musica bread, dried fava beans, pecorino cheese made from his own sheep’s milk, and a generous supply of the local Cannonau wine.

Near the village of Silanus I met Tonino Tola, a robust 75-year-old shepherd with arms like oak limbs, a vise-grip handshake, and a gladiator’s profile. I shadowed him for a day, watching him butcher animals with an ax and herd goats in the hills, sometimes tucking a straggler under each arm. At day’s end he invited me into his house for a snack. We ducked into his low-ceilinged kitchen. His wife, Giovanna, a heavy-set woman with quick, intelligent eyes, offered me wine or coffee and set out papassini—a feast day cookie made from raisins, grape juice, almonds, and fennel. “So this is what men here eat to grow so big and strong?” I asked. Tonino laughed.

I assumed that, given Sardinia’s pastoral roots and the close interdependence of people and animals, meat was a cornerstone of their diet. But Tonino corrected me. Most days, he said, he drank sheep’s milk and ate Sicilian bread, fava beans, lard, and “what my garden produced.” In the summer he and his family mostly ate zucchini, tomatoes, potatoes, eggplants, and, most significantly, fava beans. Meat was, at best, a weekly affair, boiled on Sunday with pasta or roasted during festivals. Families typically sold their animals to buy grain staples. In the winter they almost never ate meat. The sheep only ate grass and herbs. “They were very skinny,” Tonino said. “It wasn’t worth it to kill them.”

In most parts of the world, for every one guy who makes it to 100, there are five women who do too. (Good news, single men: Your dating odds improve as you get older.) But in this region of Sardinia, the ratio is one to one. And it’s not because women die young here, but rather because men elude heart disease longer—and probably better than men anywhere else in the world. For most of the past 2,000 years villagers here have lived in relative isolation from the rest of the island. (The first paved roads to the region were carved through in the 1960s.) Because the cropland is so difficult, people have had to scrape together a living by tending sheep and growing small gardens. Meanwhile, women care for children, repair the leaky roof, and handle all the finances and business negotiations. In the past women were even in charge of defense, leading the armed response to lowland intruders. They bear much of the day-to-day stress, which may help explain why men here live so long.

When you ask Sardinian centenarians to explain why they have lived so long, they’ll frequently tell you it’s the clean air, the locally produced wine, or, as one centenarian suggested, because they “make love every Sunday.” Elders here are considered cultural treasures who accrue esteem with age by holding the living memory of the culture. Older people don’t retire on Sardinia as much as they shift jobs. Men may stop tending their sheep, but they’ll put their efforts and talents to work in the villages. It’s not uncommon to see 90-year-olds working as walking patrols or advising city government. In turn, the expectation that they should contribute something to society gets them out of bed in the morning and keeps them out of the easy chair, staying active and using their brains. By and large they don’t retreat to retirement homes or senior communities. When I asked the daughter of a mentally frail 103-year-old man if she considered putting him in an old-age home, she glared at me and said, “That would shame our family.”

To find out what Sardinians actually did to become centenarians, our team’s Sardinian collaborator, Gianni Pes, examined lifestyle surveys conducted with more than 200 centenarians throughout the island. He learned that pastoralism, as he called it, was most highly correlated with reaching age 100. Shepherds who wandered the island’s highlands, moving livestock from the mountains to the plains, were up to ten times more likely to live to 100 than men in the rest of Italy, including farmers, whose lives also involved seasons of exhausting labor. Pes postulated that farmers may overwork in the growing season, leading to higher rates of inflammation. (Working too hard triggers inflammation, much the way an injury does.) We might think of shepherds as having the easier job compared to the peasants, who were thought to work much harder. But now it seems that a shepherd’s regular, low-intensity physical effort—slowly walking up and down the mountain slopes—might provide a better model for the type of exercise that the rest of us should be doing.

The second most highly associated factor for reaching age 100, Pes discovered, was the hilliness of the terrain—and how far one walked to work. The steeper the terrain, the longer you tended to live. The shepherds on Sardinia were gently walking up and down hills all day long—not just in the pastures but also in their villages. Every trip to the store, to church, or to the local bar occasioned a mildly strenuous climb.

THE SARDINIAN DIET

Searching the archives for food surveys carried out in Sardinia during the 20th century, Pes found nutritional data published in the early 1930s by Italian hygienist C. Fermi, information reflecting the lifestyle of Sardinia’s population long before dietary habits changed in the 1960s with the arrival of paved roads and generally improved economic conditions, sanitation, and public health. According to Fermi, all variables were collected through a structured questionnaire completed by public health personnel in each village. He found that in a month, people living in the Sardinian hills consumed only 3 servings of meat and 1 ounce of nuts, but also 11 pounds of wheat, 16 pounds of barley, 1 pound of cheese, and 7 liters of wine.

In 1938 another dietary researcher, G. Peretti, visited 28 farming families and 17 shepherd families living in three Sardinian villages. Overall, he found that more than 65 percent of the calories residents consumed came from carbohydrates such as bread, pastas, potatoes, or beans. Fat accounted for about 20 percent of their diet, mostly from animal sources such as goat’s milk or sheep’s cheese but also from olive oil. The other 15 percent of the diet was protein, three-quarters from plants, mostly beans. Americans tend to think that more protein is good for us. But here was a long-lived population that grew up on a low-protein diet. Recent research points to potential benefits from such a diet: A study at the Davis School of Gerontology showed that a low-protein diet is associated with lower rates of diabetes, cancer, and death for people under 65. Incredibly, for people between 50 and 65, those in the higher protein category had a 73-fold increase in diabetes risk and were more than four times as likely to die of cancer. For people over 65, the findings flipped: Those with high protein intake had a 28 percent reduction in mortality.

Potatoes were the next most important vegetable in the Sardinian diet, followed by tomatoes, onions, zucchini, and cabbage. Peretti noted only two fruits: pears and cherries. Sardinians ate about 15 pounds of cheese and 50 pounds of barley per year, he recorded. The meat they ate came mainly from sheep or occasionally pigs and chickens (mostly reserved for holidays), but never from fish. Sardinia is an island, but for residents of the highlands, the sea was a two-day round-trip journey rarely made. Wine contributed about 110 calories, or about two small glasses, to the diet of Sardinians each day. In sum, Sardinians consumed 2,720 calories per day—about what an American consumes today—but their physical activity warranted this high caloric intake.

Over the years, the Sardinian diet evolved. As roads and electricity came in during the 1960s, so did Italian influences like a taste for pasta and sweets, and a wider variety of fruits—along with the prosperity to afford them. Frozen vegetables and noodles started appearing in daily minestrone. Olive oil, while always consumed in this Blue Zone, increasingly replaced lard as the main fat used for cooking. Meat, always associated with wealth, also increased in popularity. No coincidence, then, thatobesity rates, diabetes, and heart disease have also soared in recent decades. Pes found that after 1950 Sardinians began to eat more. They replaced beans and potato consumption dropped about 40 percent, while consumption of higher-calorie foods like beef and fish increased by about 50 percent. Counterintuitively, perhaps, lard consumption dropped by 80 percent.

Typical Daily Diet of Sardinian Shepherds, 1943 (Percentage of daily intake in grams)

Meat and dairy are almost entirely from sheep and goats. Average daily wine consumption of 114 grams (4 ounces) is not included.

TOP LONGEVITY FOODS FROM SARDINIA

Many of the same Mediterranean foods that explain longevity in Ikaria also explain longevity in Sardinia. Olive oil, lemons, beans, and greens are common to both, and the Sardinian diet includes a few other longevity foods we can all benefit from eating.

  • GOAT’S MILK AND SHEEP’S MILK: Both have higher nutritional value and are more easily digested than cow’s milk. A recent study in the European Journal of Clinical Nutrition showed that both sheep’s milk and goat’s milk lower bad cholesterol, are anti-inflammatory, and may protect against cardiovascular disease and colon cancer. The higher calcium and phosphorus content of goat’s milk may have helped people living in the Sardinian Blue Zones preserve their bone density and consequently lower their risk of fractures. Goat’s milk is also rich in zinc and selenium, which are essential for optimal immune system activity and to promote healthy aging. The sharp pecorino cheese made from fermented sheep’s milk in Sardinia is particularly interesting. Because of its rich flavor, it can be used sparingly in pastas, soups, and grated over vegetables. Since pecorino is made from the milk of grass-fed sheep, it has high levels of omega-3 fatty acids.
  • FLAT BREAD (carta di musica): The most common bread consumed by Sardinian shepherds is a dry, flat bread made of high-protein, low-gluten Triticum durum wheat (the main ingredient in Italian pasta). High in fiber and complex carbohydrates, it does not cause a sugar spike in blood like processed or refined grains do and it’s easier on the pancreas, lowering the risk for type 2 diabetes. Its name comes from the observation that it is flat and thin, like music paper. Another traditional flat bread is pane carasau. This thin, flat bread made of durum wheat flour, salt, yeast, and water was invented for shepherds, who pastured their sheep for months at a time. It can last up to a year. Whole durum wheat has a low to medium glycemic score, and so it doesn’t spike blood sugar. It also contains only a fraction of the gluten that white bread does.
  • BARLEY: Ground into flour or added to soups, barley was found to be the food most highly associated with living to 100 among Sardinian men. Barley bread (orgiathu) was favored by shepherds because of its long shelf life and looked much like a regular loaf of bread but was made of ground barley. This bread has a much lower glycemic index than wheat bread, meaning it increases blood glucose more slowly than wheat bread does and thus puts less stress on the pancreas and kidneys. We don’t know if it does that because of barley’s high protein, magnesium, and fiber content (much higher than oatmeal) or because it was pushing other less healthy foods (such as white wheat flour) out of the diet. Ironically, barley was considered a poor man’s food until recently, when it has made a comeback in Sardinian haute cuisine.
  • SOURDOUGH BREAD: (moddizzosu) Much like sourdough bread in the United States, Sardinian sourdough breads are made from whole wheat and use live lactobacilli (rather than yeast) to rise the dough. This process also converts sugars and gluten into lactic acid, lowering the bread’s glycemic index and imparting a pleasant, faintly sour taste. Pes has demonstrated that this type of bread is able to lower the glycemic load, reducing after-meal glucose and insulin blood levels by 25 percent. This helps protect the pancreas and may help prevent obesity and diabetes.
  • FENNEL: Fennel’s licorice taste flavors several Sardinian dishes. It’s used as a vegetable (the bulb), as an herb (its willowy fronds), and as a spice (its seeds) and is rich in fiber and soluble vitamins such as A, B, and C. It’s also a good diuretic; therefore, it helps to maintain the blood pressure low.
  • FAVA BEANS AND CHICKPEAS: Eaten in soups and stews, fava beans and chickpeas play an important part in the Sardinian diet, delivering protein and fiber. They are one of the foods most highly associated with reaching age 100.
  • TOMATOES: Sardinian tomato sauce tops breads and pizzas and is the base for several pasta dishes. Tomatoes are a rich source of vitamin C and potassium. Cooking tomatoes breaks down their cell walls, making lycopene and other antioxidants more available. The Sardinian custom of coupling olive oil with tomatoes (either drizzling it over raw tomatoes or using it to make sauces) further increases the body’s ability to absorb nutrients and antioxidants.
  • ALMONDS: Almonds, associated with Mediterranean cooking everywhere, appear regularly in Sardinian cooking, eaten alone, chopped into main dishes, or ground into a paste for desserts. One study showed that almonds included in a low-calorie diet helped people lose more weight and belly fat while they experienced an increase in protective high-density lipoprotein (HDL) cholesterol and a drop in systolic blood pressure (the bottom number).
  • MILK THISTLE: Sardinians drink a tea of milk thistle, a native wild plant, to, as locals believe, “cleanse the liver.” Emerging research suggests that the milk thistle’s main active ingredient, silymarin, is an antioxidant and has anti-inflammatory benefits. It can be found in American health food stories as an ingredient in some herbal teas and in capsule and tablet form.
  • CANNONAU WINE: Sardinia’s distinctive garnet red Cannonau wine is made from the sun-stressed Grenache grape. When I first traveled there, I was hoping to discover a longevity elixir in this wine. Sardinians drink three to four small (three-ounce) glasses of wine a day on average, spread out between breakfast, lunch, dinner, and a late afternoon social hour in the village. One might argue that the all-day small doses of this antioxidant-rich beverage could explain fewer heart attacks. Dry red wines in general offer the same health advantage.


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