What Costa Rica’s Longest-Lived Men Teach Us About Healthy Aging

Deborah Kan is an award-winning journalist and founder of Being Patient. In this “Thought of the Week” column each Friday, she highlights one of the key stories shaping the future of brain science.

Dear readers,

Greetings from a family vacation in Costa Rica. We were heading into the rainforest when our guide Danny mentioned, almost in passing, that we weren’t far from the Nicoya people and one of the small number of places on earth where an ordinary person has an extraordinary chance of reaching 100. I’d read the skeptics’ takes, the ones arguing these longevity zones were really just regions with sloppy record keeping and unreported deaths. But Costa Rica is one place that kept meticulous records, birth registries dating back to the 1880s. 

When I got back to our hotel, I started to look at the published studies on the Nicoya people and what I learned surprised me.  

In Nicoya, the people reaching those remarkable ages are mostly men. That runs against nearly everything we assume about aging: women almost always outlive men. A 60-year-old man in Nicoya has roughly seven times the chance of a Japanese man of reaching 100, and Japan is one of the longest-lived countries in the world. For Nicoyan women, that exceptional advantage simply doesn’t show up. Whatever is happening here, it is happening to the men.

Our guide had a theory: These are farming people, he told us, the men work the land into old age, eating simply from what they grow. What the researchers could measure was a small edge in physical activity but that didn’t reach statistical significance. They did find a clue in the men’s own biology.

When scientists looked closely at Nicoyan men, the clearest difference was cardiovascular. Their whole longevity advantage traces back to lower rates of heart disease, and the markers underneath tell a consistent story. They carried lower triglycerides, lower blood sugar, lower cholesterol, smaller waists. They were leaner and, notably, taller than other Costa Ricans, a sign of healthier nutrition early in life. Two markers tied to biological aging and stress, telomere length and a hormone called DHEAS, were more favorable in Nicoyans, contributing to a body aging more slowly. These men took far fewer blood pressure and cholesterol medications than other Costa Ricans. 

Diet was part of it, though not in a significant way. The traditional Nicoyan diet leaned on rice, beans, squash and a small amount of animal protein, with more fiber and a lower glycemic index than the national average, the kind of eating that aligns with what we now understand supports cardiovascular health. But the differences the researchers actually measured were small, and they were careful to warn against crowning any single food the secret to longevity. It was more a whole way of living.

A small genetic study found that Nicoyans with more Indigenous Chorotega ancestry tended to live longer, raising the possibility that some inherited protection is part of the story. This study was tiny, just 40 people, and its authors called it a first hint rather than a conclusion. But it points at something the whole Nicoya picture keeps suggesting, that longevity here is woven from many strands, environment and heart health and habit, and perhaps heredity, not one you could point to.

Danny mentioned that the modern way of living is erasing the longevity advantage to this region. The men who lived these exceptional lives were born before 1930. The generations that followed are not reaching the same ages, and researchers watching the region believe modernization is quietly eroding whatever made it exceptional. This is not unique to Costa Rica. Okinawa in Japan, once the most famous longevity zone of all, is also losing its advantage to  the modern world. These places are not permanent monuments, and we may be losing the chance to truly understand what makes these people live longer.

If there is something to take away from the Blue Zones, it’s that the people who lived longest were not chasing longevity at all. They moved because their days required it, they ate simply because that was the food, and they stayed connected to their families and communities until the end. The same themes surface every time I report on healthy aging, including in my conversations with the researchers behind the 90+ Study, who found that longevity tracks not with any single food but with staying physically and socially engaged across a lifetime. That couldn’t be a coincidence.

With hope,
Deborah