Older adults who have never smoked, are currently exercising, and have a more diverse diet are more likely to become centenarians, a new study finds.
As life expectancy increases globally and the aging population rapidly expands, the challenge of promoting healthy aging and longevity arises.
A new study published in JAMA Network Open examined lifestyle behaviors that could help people live up to 100. The study comprised 5,222 Chinese adults aged 80 and older, including 1454 identified centenarians and 3,768 controls who died before turning 100.
Participants' lifestyles were evaluated using a healthy lifestyle score for 100 (HLS-100) that took into account factors like smoking, alcohol use, exercise, dietary diversity, and body mass index (BMI). The higher scores in the HLS-100 indicated potentially better health outcomes.
During a five-year follow-up, 373 of 1486 individuals who scored the lowest on HLS-100 and 276 of 851 individuals among the highest HLS-100 group became centenarians.
Following a healthy lifestyle was also associated with relatively good health, as evaluated by self-reported chronic conditions, physical and cognitive function, and mental wellness.
“Adhering to a healthy lifestyle appears to be important even at late ages, suggesting that constructing strategic plans to improve lifestyle behaviors among all older adults may play a key role in promoting healthy aging and longevity,” the authors concluded.
Meanwhile, higher BMI may have a protective role in mortality risk in older populations. Low BMI at a very advanced age may reflect potential malnutrition and other chronic conditions rather than being an indicator of lifestyle.
Previous research, but not this study, suggested that moderate alcohol consumption was not necessarily related to adverse health outcomes, the authors point out. However, an extensive review of studies from 2023 suggests that even moderate drinking can increase the risk of death from all causes.
The new study, however, may be subject to bias because lifestyle behaviors were self-reported, and people may not be able to accurately remember what they ate or how much they exercised, among other factors. The disease prevalence could have been underestimated as participants also self-reported medical conditions.
How do I become a centenarian?
Aging populations also place a heavy financial burden on healthcare systems. In 2030, one in five Americans will be of retirement age and eligible for Medicare coverage, putting its annual acute care costs around $259.8 billion. The projections underline the importance of improving health span and increasing life expectancy.
Meanwhile, scientists are still trying to figure out the secret of living to 100 years and more.
Studies have indicated that genes play only a minor role and may be responsible for about 25% of a person’s lifespan. Other research has suggested that only two genes, APOE and FOXO3A, which help protect against cardiovascular diseases, have been associated with longevity.
A study from 2023 suggests that centenarians might possess a specific group of immune cells that secure them from illnesses.
Therefore, the environment and lifestyle behaviors appear to have the most significant influence on living long and healthy.
For example, some researchers look at the Blue zones or regions where people have exceptionally long life expectancies. In these regions, individuals follow a predominantly plant-based diet that emphasizes vegetables, fruits, whole grains, and legumes. They also have a limited intake of processed foods and red meat.
Exercising, eating a diverse diet, and avoiding bad habits like smoking and drinking alcohol can lead to a longer and healthier life, and these behaviors can be started even at an advanced age.
4 resources
- JAMA Network Open. Healthy lifestyle and the likelihood of becoming a centenarian.
- Emarketer. The aging US population is creating many problems—especially regarding elderly healthcare issues.
- National Library of Medicine. Special issue “Centenarians—a model to study the molecular basis of lifespan and healthspan 2.0.”
- JAMA Network Open. Association between daily alcohol intake and risk of all-cause mortality.
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