What researchers hope to learn from one Italian region’s oldest residents

I recently returned from a wonderful vacation in Italy, so naturally, the Cilento Initiative on Aging Outcomes (CIAO) conference, which kicks off today in Acciaroli Salerno, Italy, caught my attention. 

The May 22-23 symposium, officially titled the “CIAO Study: A decade of science on healthy aging, stem cells and the revealed secrets of longevity,” will feature a series of scientists and physicians describing their work and findings, from general demographic and epidemiological aspects to deeper dives into brain cell aging, the regenerative powers of stem cells and RNA biology, according to Sanford Burnham Preys, an independent biomedical research institute in San Diego that is collaborating on the long-term study.

Journalists can reach out to the presenters, many of whom are based in the U.S. to learn more about the study outcomes and how we can adapt or adopt some of these approaches to longevity and health span in America. Experts and bios are noted on pages 6-7 of the conference brochure and media contacts are listed below. 

Why this matters

This region of Italy is considered an undefined Blue Zone, an area of the world, where people live long and relatively healthy lives. By analyzing key commonalities among these different areas, scientists can better pinpoint what helps people not only enjoy a longer lifespan, but a longer health span. This work has implications for cities, states, and communities throughout the United States, as well as globally. 

Keeping people healthier longer delays or prevents the need for institutional care, allows people to live independently longer, reduces health care costs, and allows family caregivers to keep working. Journalists may want to explore efforts by their states or communities to see if any adopt approaches that can improve not only life span, but health span, such as access to nutritious foods, walkable neighborhoods, and efforts to reduce chronic diseases of aging such as heart disease, diabetes, and Alzheimer’s.

Proponents of the Blue Zone theory say modeling similar healthy behaviors — sensible diet, exercise, socialization, managing stress and having a sense of purpose — can foster healthier aging. However, these claims have also sparked significant controversy, including criticism of existing data, claims of faulty record keeping, and even accusations of fraud. Just like many approaches and products that claim to promote longevity or health, reporters should view any data and results with a healthy skepticism and assess data objectively.

A new Blue Zone?

The Cilento region in southern Italy is home to roughly 300 residents who are more than 100 years old and in good health. The broader region is notable for the long lives of its residents, according to Sanford Burnham Prebys. The Cilento area was the original source of research for American physiologist Ancel Keys, who studied the influence of diet on health and first promoted the benefits of the Mediterranean diet.

This cohort has very low rates of heart disease and Alzheimer’s. It favors a Mediterranean diet which heavily relies on the herb rosemary. Due to the location of the village, locals also walk long distances and hike through the mountains as part of their daily activity, according to Alan Maisel, M.D., the lead UC San Diego School of Medicine investigator when the study began in 2016. 

A decade later, the team of scientists hopes to solidify the longevity secrets of the Cilento region using an array of tools to measure metabolomics, biomes, cognitive dysfunction and protein biomarkers for risk of heart disease, Alzheimer’s, kidney disease and cancer, along with psychological, social and lifestyle surveys. 

“There is no single secret to living a long, healthy life,” Salvatore DI Somma, M.D., the study’s lead Italian investigator and symposium co-chair said in a statement. “It is many secrets, most of which we are only beginning to understand and more importantly, learn how they might be applied to the well-being of everybody.”

One current CIAO project leverages genetic, epigenetic, transcriptomic, or mRNA, metabolic, proteomic and environmental analyses to identify key contributors to extreme longevity. Researchers are using stem cells derived from the centenarians to model age-related and metabolic stresses in human 3D organoids — artificially grown masses of cells or tissues that resemble organs.

“This study will provide new insights into the development of regenerative medicine strategies for promoting healthy aging and treating age-related conditions,” said Tatiana Kisseleva, M.D., Ph.D., professor of surgery at UC San Diego School of Medicine and director of the Sanford Stem Cell Fitness and Space Medicine Center.  Preliminary findings are expected to be presented at the symposium.

Other participants in the multi-institution collaboration includes the Sanford Stem Cell Institute at University of California San Diego, University La Sapienza in Rome and Great Health Science, a network of public and private research organizations based in Rome, Italy. 

Resources

• What do we know about healthy aging?  National Institute on Aging.
• Original Blue Zones exploration.
• The longevity hotspots that weren’t, The New Republic.
• Mediterranean diet in healthy aging, Journal of Nutrition, Health and Aging, 2021.
• Healthy Lifestyle and the Likelihood of Becoming a Centenarian, JAMA Open, 2024.