A 1999 study of elderly people living on Sardinia found a prevalence of 13
centenarians per 100,000 population, indicating unusual longevity. A 2004 followup report showed that longevity was concentrated in the Nuoro province of Sardinia, specifically in its mountain regions where locally born men lived longer than those in the rest of Sardinia, although reasons for the longevity were unknown. Beginning in 2005, the list of blue zone regions was extended from Sardinia to include Okinawa, Nicoya in Costa Rica, and Icaria in Greece.
Michel Poulain added
Martinique as a possible blue zone in 2019,
Estimating population longevity In the original study of centenarians living in 14 mountain villages of Sardinia (the first proposed blue zone), the research team developed an
Extreme Longevity Index (ELI) representing the ratio between the number of eventual centenarians born between 1880 and 1900, and the total number of births recorded during the same time interval for the region. While the study acknowledged that modernization can cause longevity patterns to shift or disappear, it proposed that these regions serve as "natural laboratories" for understanding how lifestyle, diet, and social connectivity may contribute to healthy aging. Core longevity factors found in this study were diet, physical activity, social support, and environment. The authors concluded "with reasonable confidence that these blue zones of exceptional longevity do indeed exist, even if there are indications that this exceptionality is transient and may be transitory. Given the rapid aging of populations in many modern societies, blue zones should be considered as a valuable model for promoting longer, healthier, and happier lives." == Critiques ==