Are there any blue zones in America?

Globally, Blue Zones are areas where lifestyle habits promote longevity. Few habits affect overall well-being more than a healthy diet, and the probability of eating well largely depends on one’s place of residence.

The “2016 Community Rankings for Healthy Eating” report examines the wide range of eating habits nationwide [1]. According to the May 3rd report published by Gallup-Sharecare, a partnership between the polling organization and the digital health company, ten communities in California, four in Florida, and two each in Texas and Arizona have the healthiest eating habits in the nation. The Naples-Immokalee-Marco Island, Florida, metropolitan area leads the country, with more than 75% of residents reporting healthy eating.

Here’s a review of the 25 metro areas with the highest shares of residents reporting healthy eating habits. Also examined were several other factors research has shown to influence diet and associated health outcomes.

In its poll, Gallup asked metro area residents, “Did you eat healthy all day yesterday?” Dan Witters, research director of the Gallup-Sharecare Well-being Index, said that while health literacy can influence how people respond to this question, “most people have a pretty good idea of what it means to eat healthy or not.”

To put it another way, healthy eating decisions are conscious choices. Several key well-being metrics, including the presence of someone who encourages you to be healthy and notably stress levels, support healthy diets. 

Of the 25 cities where the largest share of residents eat healthy diets, only nine reported above-average daily stress levels. Nationwide, 40% of adults reported daily stress.

In addition to solid relationships, income levels and money management are closely related to dietary decisions. The ability to pay for high-quality food is often a limiting factor for low-income families. Fruits, vegetables, and fresh produce, which are some of the most beneficial additions to a healthy diet, also frequently happen to be among the higher-priced items at the grocery store.

The median household income in 16 of the 25 cities with the healthiest diets is higher than the national median of $55,775 annually. While financial constraints can contribute to poor diets, Michael Acker, director of the Blue Zones Project at Sharecare, noted that healthy eating decisions are entirely possible on low incomes. 

Blue Zones projects, which are programs that implement features of long-living communities worldwide and other community efforts like farm-to-table programs, food policy councils and community gardens can contribute to healthy outcomes even in low-income communities. For Acker, while individuals generally know whether they are eating healthy, they only sometimes understand the outcomes of particular eating habits, especially in poorer, economically disadvantaged communities. 

Acker explained, “The common perception is that things like diabetes and heart attack in your family are primarily genetic, and we know this is simply not true for the most part.” By educating communities on the effects of lifestyle on health, community organizers and health advocates have successfully improved diets across a population.

In the areas with the healthiest diets, adverse health outcomes are considerably less expected than across populations reporting poor eating habits. The probability of being obese, for example, declines substantially for people who eat healthily. 

Only two of the 25 cities with the healthiest diets have an obesity rate greater than 30%. Only nine have obesity rates over 25%.

Regarding the question if there are any blue zones in America, these are the 25 cities with the healthiest diets [1]:

25. Daphne-Fairhope-Foley, AL

Adults who eat healthy all day: 68.4%

Median household income: $52,003

Adults with daily stress: 46.0%

Obesity rate: 27.4%

24. Oxnard-Thousand Oaks-Ventura, CA

Adults who eat healthy all day: 68.5%

Median household income: $80,032

Adults with daily stress: 39.5%

Obesity rate: 20.3%

23. Vallejo-Fairfield, CA

Adults who eat healthy all day: 68.5%

Median household income: $67,443

Adults with daily stress: 46.0%

Obesity rate: 30.1%

22. Durham-Chapel Hill, NC

Adults who eat healthy all day: 68.7%

Median household income: $54,160

Adults with daily stress: 38.6%

Obesity rate: 27.7%

21. Charlottesville, VA

Adults who eat healthy all day: 68.7%

Median household income: $63,918

Adults with daily stress: 40.5%

Obesity rate: 25.6%

20. San Jose-Sunnyvale-Santa Clara, CA

Adults who eat healthy all day: 69.2%

Median household income: $101,980

Adults with daily stress: 40.8%

Obesity rate: 19.6%

19. San Francisco-Oakland-Hayward, CA

Adults who eat healthy all day: 69.3%

Median household income: $88,518

Adults with daily stress: 40.6%

Obesity rate: 20.6%

18. San Diego-Carlsbad, CA

Adults who eat healthy all day: 69.4%

Median household income: $67,320

Adults with daily stress: 38.2%

Obesity rate: 19.1%

17. Santa Maria-Santa Barbara, CA

Adults who eat healthy all day: 69.4%

Median household income: $63,625

Adults with daily stress: 36.1%

Obesity rate: 18.2%

16. North Port-Sarasota-Bradenton, FL

Adults who eat healthy all day: 69.6%

Median household income: $53,698

Adults with daily stress: 29.9%

Obesity rate: 22.8%

15. Prescott, AZ

Adults who eat healthy all day: 69.7%

Median household income: $48,105

Adults with daily stress: 30.7%

Obesity rate: 25.3%

14. Boulder, CO

Adults who eat healthy all day: 69.9%

Median household income: $72,009

Adults with daily stress: 48.8%

Obesity rate: 13.4%

13. Ocala, FL

Adults who eat healthy all day: 69.9%

Median household income: $40,050

Adults with daily stress: 38.4%

Obesity rate: 29.2%

12. Bridgeport-Stamford-Norwalk, CT

Adults who eat healthy all day: 70.0%

Median household income: $86,414

Adults with daily stress: 43.1%

Obesity rate: 21.4%

11. Miami-Fort Lauderdale-West Palm Beach, FL

Adults who eat healthy all day: 70.5%

Median household income: $50,441

Adults with daily stress: 37.7%

Obesity rate: 22.2%

10. El Paso, TX

Adults who eat healthy all day: 70.9%

Median household income: $43,633

Adults with daily stress: 35.2%

Obesity rate: 28.4%

9. Lake Havasu City-Kingman, AZ

Adults who eat healthy all day: 71.0%

Median household income: $40,908

Adults with daily stress: 36.1%

Obesity rate: 29.6%

8. San Luis Obispo-Paso Robles-Arroyo Grande, CA

Adults who eat healthy all day: 72.0%

Median household income: $62,648

Adults with daily stress: 40.2%

Obesity rate: 24.5%

7. Hilton Head Island-Bluffton-Beaufort, SC

Adults who eat healthy all day: 72.0%

Median household income: $55,923

Adults with daily stress: 37.5%

Obesity rate: 24.0%

6. Santa Rosa, CA

Adults who eat healthy all day: 72.3%

Median household income: $66,674

Adults with daily stress: 38.9%

Obesity rate: 20.9%

5. McAllen-Edinburg-Mission, TX

Adults who eat healthy all day: 72.4%

Median household income: $35,730

Adults with daily stress: 38.8%

Obesity rate: 34.4%

4. Salinas, CA

Adults who eat healthy all day: 72.9%

Median household income: $60,494

Adults with daily stress: 38.0%

Obesity rate: 22.3%

3. Santa Cruz-Watsonville, CA

Adults who eat healthy all day: 74.2%

Median household income: $65,139

Adults with daily stress: 44.0%

Obesity rate: 20.2%

2. Barnstable Town, MA

Adults who eat healthy all day: 75.1%

Median household income: $66,102

Adults with daily stress: 35.0%

Obesity rate: 19.9%

1. Naples-Immokalee-Marco Island, FL

Adults who eat healthy all day: 75.3%

Median household income: $62,126

Adults with daily stress: 27.9%

Obesity rate: 19.5%

To identify the 25 cities with the healthiest diets, metro areas with the highest percentages of adults reporting eating a healthy diet all day the previous day from Gallup-Sharecare Well-being Index were examined [2].

Between January 2nd, 2015 and December 30th, 2016, Gallup conducted 354,473 telephone interviews with US adults from all 50 states and the District of Columbia. Metropolitan Statistical Areas (MSAs) are based on the US Office of Management and Budget definitions. Only MSAs with at least 300 completed interviews were considered.

Gallup also reported the percentage of adults who reported daily stress. The median household income was obtained from the US Census Bureau’s 2015 American Community Survey. The adult obesity rate is from the CDC (Centers for Disease Control and Prevention) for 2013, the most current year for which data is collected.


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