Why Do Italians Live So Long?

Italy has been known to hold a high position in life expectancy world rankings for a long time and, as of 2020, it is in 6^th position, sitting considerably higher than the UK (29^th position) and the US (46^th position). The average Italian lives 84.01 years, the average Briton lives 81.77, and the average American lives 79.11 years. Italy is one of the top eight countries in the world with the highest percentage of the total population over the age of 100.

Many have been wondering what causes this increased longevity in Italians. 

Italians live so long because of a combination of different factors: the Mediterranean diet, characterised by fruit and vegetables with a higher vitamin content, and a preference for olive oil over animal fat, favourable weather conditions, which directly or indirectly influence lifespan, and healthy lifestyle habits, such as more time spent outdoors and low levels of alcohol consumption. It is possible that generic heritage may also play a favourable role.

Complex phenomena such as life expectancy don’t have one single cause. Rather, they are determined by a number of different contributing factors. Keep reading to see how these factors contribute to Italians having a longer life expectancy than other countries.

Is longevity hereditary? Genetics only helps a little!

Genetics have been found to account for about 25% of variations in life expectancy, therefore it is likely that longevity runs within families.

Based on this, it is certainly possible that the Italians’ genetic make-up contributes to their longevity. However, we need to remember that this leaves another 75% of variation in life expectancy not accounted for by genetics, and so we need to also look at other factors, for example lifestyle, to fully understand longevity.

When drawing conclusions about genetically-inherited characteristics, it is also important that we don’t lose sight of the chicken-or-egg question. In fact, it is possible for your lifestyle, such as spending a lot of time doing physical work in the sun, to change how your genes work, a topic studied in the complex and fascinating field of epigenetics, and for those epigenetic changes to then be passed on to subsequent generations.

So it is possible that the Italian genetic heritage which contributes to longevity in the Italians would have been triggered by lifestyle factors in the first place.

This is good news, as it means that there is a lot that many of us can do to increase our chances of greater longevity.

What is the Mediterranean diet, and can it help you to live longer?

One of the most commonly talked about aspects of the Italian lifestyle is the Mediterranean diet.

The Italian Mediterranean diet consists of a high quantity of in-season fruit and vegetables, and wholegrain bread and pasta as the main carbohydrate sources. Proteins mainly come from legumes, seeds, fish and white meat. Red meat and sugars are consumed in moderation. Importantly, a generous amount of olive oil is used in cooking and as a condiment.

Does the Mediterranean diet play a role in why Italians live so long? There is a lot of evidence to suggest that it does.

You might have heard of Acciaroli, a town in the Campania region of Italy which is famous for the longevity of its population, where 1 in 10 people live until they are 100 years old. The older people of Acciaroli were studied for their longevity, and they were found to have excellent circulation. Circulatory diseases, which are the number-one cause of death globally, were non-existent for the people of Acciaroli. This was attributed to their diet.

The two main tenets of the Italian diet, which separate it from the diet of the US and the UK are fresher and more local produce (not only fruit and vegetables, but also fish and meat), and preference of olive oil over animal fat. Fruit and vegetables are a very ingrained habit in the diet of the Italians and are consumed every day in larger quantities than other countries, at lunch and dinner, and some people eat fruit in-between meals.

Especially in smaller cities and towns, Italians tend to prefer shopping at small local businesses, such as family-run greengrocers, butchers and bakeries. There are fewer large supermarket chains, although this has been changing throughout the years, and more and more large supermarkets are popping up everywhere.

Small family-run greengrocers, do not sell any out-of-season produce, as this comes from their own land, which means that it is fresher, has a higher vitamin content, and is less likely to contain large quantities of harmful pesticides and other chemicals.

These fruit and vegetables also taste better, which is one of the reasons why it is consumed in larger quantities, often at the end of a meal, instead of dessert.

The incredible benefits of olive oil

There is a lot of research suggesting that olive oil plays a very important role in the benefits of the Italian Mediterranean diet for longevity. In fact, olive oil has been shown to have a direct effect in increasing longevity and to also decrease the risk of diabetes and heart disease, as well as several other benefits.

For Italians, olive oil is the condiment of choice. At every meal, one to three tablespoons of uncooked extra-virgin olive oil are drizzled on all vegetables and salads, on meat and fish, and even sometimes on pasta which already comes with its own sauce. It’s easy to see how this considerably bumps up intake of this very good fat.

The Italians and drinking

Alcohol consumption is responsible for 2.8 million premature deaths per year, and heavy drinking reduces life expectancy by up to five years. So, when talking about the Italian diet, it is important to look at drinking habits as well.

What do the Italians drink? How much do they drink, and how do they drink?

The Italians drink wine for the vast majority, but in moderation (see table below), compared to other countries. There is some evidence to show that a small daily amount of red wine may contribute to cardiovascular health because of the beneficial antioxidants it contains. Whether red wine has contributed to the Italian’s longevity or not, we can be confident that red wine is one of the least harmful types of alcohol.

Italians mostly drink in company and with their food, which minimises the harmful effects of alcohol and its impact on the body. A number of older people also have a habit of diluting their wine with water. As unappealing as this is to most, it may have contributed to reducing overall alcohol intake in this older generation during their lifetime.

Drinking in its most harmful form, that is binge drinking, has a low prevalence in Italy, compared to other countries (see table below), although this is a tendency that is now changing in the younger generations, possibly due to the information spreading and mobility that come with increasing globalisation.

The table below compares the “what”, “how much” and “how” of alcohol consumption in the US, UK and Italy.

	United States	United Kingdom	Italy
Wine as a share of total alcohol consumption	17.3%	33.8%	65.6%
Per capita alcohol consumption (kg per year)	93.9	93.14	59.21
Share of drinkers who have had a heavy drinking session in the past 30 days	24.5%	33.4%	6.2%

As for non-alcoholic drinks, the large majority of Italians still prefer to drink water, particularly in smaller towns, where there are no large supermarkets or fast food chains, and people have not formed a habit of drinking anything other than water. Again, this is fast changing, especially in the younger generations. The low consumption of sugary and carbonated drinks plays a large part of lowering risk of diabetes, obesity, and associated cardiovascular problems.

When considering how the Italian Mediterranean diet influences longevity, we need to bear in mind that Italy has been heavily reliant on agriculture, raising livestock, and fishing for a long time. When considering the economic growth of Italy in comparison to that of the US and the UK, in 1945 the GDP per capita gap between Italy, the US and UK was at its largest, and it wasn’t until 1979 that the difference got smaller.

	Year 1945	Year 1979
Italy	$2,831	$20,275
United States	$16,478	$29,949
United Kingdom	$11,247	$20,988

The older generation of Italians reaped the benefits of this healthy lifestyle. They consumed a lot of fruit and vegetables, which has been shown to increase lifespan, had very little to no access to processed food, and drunk alcohol in moderation. The low use of animal fat, and high use of olive oil has been shown to reduce risk of heart disease and circulatory problems. This healthy diet, in addition to the physical activity that this generation carried out on a daily basis when working on the land, at sea, or with livestock, provided them with a recipe for a longer life.

How does the weather affect us?

Italians enjoys mostly sunny weather throughout the year, with low levels of precipitation. The benefits of good weather are likely to influence longevity in the Italians by favouring physical and psychological conditions which promote a longer life.

How good weather benefits our physical health

Temperatures like those of the Mediterranean climate, when they remain within the thermoneutral zone (between 20°C and 25°C) allow us to feel at our best because they don’t require us to thermoregulate, by shivering or sweating, which depletes our body from energy. This encourages us to spend more time outdoors, which brings a number of benefits.

Italians spend a lot of time outdoors mainly to see friends or have a walk, which often go together. It is also very important to remember that the beach is a pleasant place to be all year round, and swimming or sunbathing is possible from mid-May to beginning of October, and, in the southern regions even until end of November. Italians who live on the coast or close to the coast visit the seaside several times a week.

Sun exposure has been shown to be important in synthetizing vitamin D in the body. As well as providing a number of benefits such as increasing bone density, improving the immune system, lowering blood pressure, decreasing asthma and preventing cancer, vitamin D has also been shown to directly increase longevity.

How good weather affects our mental wellbeing

Good weather is also widely agreed to directly improve our mental wellbeing in two main ways:

• Sunlight exposure boosts production of serotonin which has positive effects on mood, appetite, sleep, learning and memory. You may have heard of Seasonal Affective Disorder, a mood disorder which affects a large number of people in the winter months.

• Stronger sun light leads to better sleep-wake patterns, which, in turn, has beneficial effects on our mental health, as well as our physical health.

What is the Italian way of life and does it contribute to longevity?

Some have suggested that a more “relaxed” pace of life, better work/ life balance, and a supportive social structure may be responsible for the Italians’ longevity because they contribute to a less stressful life overall.

Stress has indeed been shown to shorten life expectancy, but can we say that low stress levels play a role in why the Italians live longer? Let’s look at similarities and differences in how time is spent in daily life in the US, UK and Italy. The table below shows time, in minutes, spent engaging in different activities within the three countries.

These data show that amounts of time spent in most daily activities are not massively different between the US, UK and Italy. However there are three interesting differences:

• Italians spend the least amount of time doing “paid work and education”. Of note, data for the US, UK and Italy were extracted from a list of 23 countries, and Italy was the country with the smallest amount of time spent doing paid work. Instead of being indicative of a better work/ life balance, or a more relaxed pace of life, this difference is highly likely to be a reflection of the higher rate of unemployment in Italy (11.21%) compared to the US (4.36%) and the UK (4.33%) (Data source: World Bank – data from 2017).

• Italians spend a lot of time eating and drinking, twice as long as the Americans do. Eating and drinking in Italy is done, for the most part, around the table with family and friends, and is a long-standing tradition in the Italian culture.

• Italians spend more time seeing friends and engaging in “other leisure” activities than the US and the UK. “Other leisure” is likely to be time spent outdoors, often walking with friends and family. The greater social bonding, exposure to sunlight and being physically active are all factors which can contribute to a longer life.

It is difficult to draw firm conclusions as to whether the Italian way of life in today’s world can contribute to longevity. Although family bonding and social interaction are certainly important for wellbeing, the scarce job opportunities also mean that it is difficult for young people to leave the family home and build an independent life, which might actually make life more stressful in the young Italian people today.

Final thoughts: we have to turn our attention to the centenarians

To understand longevity in the Italians, and to learn what we can do to extend our longevity, we have to turn our attention to the older generations and their lifestyle, which included plenty of time doing physical activity outdoors, low levels of stress and a healthy diet, all factors which have been shown to play a role in increasing lifespan.

Many Italians who live in smaller towns and villages have managed to preserve a simple, more traditional and less modernised way of life. However, life in the big cities is now much more globalised than it used to be, meaning that people’s diets and habits are no longer as healthy as they once were.

Stress levels, in general, are high in the younger generations, who have been experiencing, and continue to experience, a great deal of uncertainty about their futures.

Unless these younger generations make a conscious effort to preserve a healthy lifestyle, we might see the life expectancy statistics for Italy change in years to come.