The number of centenarians worldwide has increased from 151,000 in 2000 to 573,000 in 2021. People are living longer and we can expect more people to reach the age of 100 in the coming years.
Centenarians are an example of successful aging, often suffer less from chronic diseases and are independent in everyday life well into their 90s. While genetics contribute to longevity, modifiable factors are responsible for more than 60 percent of successful aging.
But what factors specifically contribute to living to 100 years? To find out, we examined the lifestyle and health habits of centenarians and near-centenarians (95 to 99 year olds) around the world.
Our recent review included 34 observational studies published since 2000. Here are four key factors we believe contribute to extremely long lifespans.
1. A varied diet with controlled salt intake
Centenarians and near-centenarians tended to have a balanced and varied diet. We found that on average they derived between 57 and 65 percent of their energy intake from carbohydrates, 12 to 32 percent from proteins, and 27 to 31 percent from fats. Their diets included staple foods (such as rice and wheat), fruits, vegetables, and protein-rich foods such as poultry, fish, and pulses, with moderate consumption of red meat.
This dietary pattern is similar to the Mediterranean diet and is associated with a lower risk of physical dysfunction and death.
Most centenarians also preferred a low-salt diet. Although only one study in our report measured average daily sodium intake and found 1.6 grams, this was within the World Health Organization’s recommendation of less than 2 grams of sodium per day (equivalent to about 5 grams of salt). The traditional Okinawan diet, known for its consumption by Japanese centenarians on the island of Okinawa, contains an estimated 1.1 grams of sodium.
We found that people with higher salt intake (who preferred salty foods or added salt to meals) had a 3.6-fold higher risk of impaired physical function compared to people without a salt preference.
In practice, these findings suggest that we should include plenty of whole grains, root vegetables, beans, legumes, fruits and vegetables in our diet, minimize red meat consumption and favor lean poultry, fish and vegetable protein, and pay attention to the salt content of our foods.
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2. Reduced medication use
Centenarians are not free from chronic diseases, but they typically develop them much later than average adults. More than half of the people in our study suffered from general problems such as hypertension (high blood pressure), dementia or cognitive impairment.
We found that people in our study took an average of 4.6 medications. The most commonly used medications were blood pressure medications and heart disease medications. This is similar to the results of a large health registry-based study in Spain, which found that centenarians took an average of 4.9 medications. The non-centenarians in that study took an average of 6.7 medications.
The fact that centenarians appear to take fewer medications may indicate better health and fewer illnesses. However, data on medication use are often self-reported and may therefore not be entirely accurate, particularly in people with cognitive impairment.
Polypharmacy is often defined as the simultaneous use of five or more medications and is common in older adults. Inappropriate polypharmacy is associated with an increased risk of adverse events such as falls, cognitive impairment, and hospitalizations due to harmful drug interactions.
Even if the patient has no influence on the type or number of medications prescribed, it is important for the doctor to prescribe medications only when necessary, to provide the patient with comprehensive information about the benefits and risks, and to regularly review the treatment plan.
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3. Sleep well
Sleep quality and quantity affect the immune system, stress hormones, and cardiometabolic functions such as obesity, hypertension, and diabetes. Good sleep is associated with longer years of good health and a lower risk of chronic disease.
In our study, 68 percent of centenarians were satisfied with their sleep quality. In a 2020 survey of sleep satisfaction among adults in 13 countries, sleep satisfaction ranged from 29 to 67 percent.
The optimal amount of sleep is between seven and eight hours per night. Tips for better sleep include regular sleep routines, creating a restful environment, regular exercise and stress management.
4. Living environment
More than 75 percent of centenarians and near-centenarians in our study lived in rural areas. This pattern is reflected in the “blue zones,” areas known for high concentrations of centenarians, such as Okinawa in Japan, Sardinia in Italy, the Nicoya Peninsula in Costa Rica, and Ikaria in Greece.
This may be partly related to the link between nature and health and wellbeing. For example, spending time in green spaces has been linked to lower levels of stress, depression, blood pressure, type 2 diabetes and heart disease, potentially leading to increased life expectancy.
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Other important factors
We did not consider all lifestyle factors associated with longevity in our research. Research also shows that not smoking, not drinking alcohol or drinking it in moderation, being physically active and maintaining social contacts are important in increasing a person’s chances of reaching 100.
Of course, implementing the lifestyle changes described in this article is no guarantee that you will reach the ripe old age of 100. And on the other hand, some centenarians have engaged in health-damaging habits that are questionable.
But many older people are striving for a healthier lifestyle to prevent and manage chronic diseases. Medical professionals are also recognizing the value of lifestyle medicine.
The sooner you adopt positive lifestyle changes and healthier habits, the better your chances of living a long and healthy life. Living to be a centenarian is a lifelong endeavor.
Zhaoli Dai-Keller is a lecturer at the University of New South Wales and Perminder Sachdev is Scientia Professor of Neuropsychiatry at the University of New South Wales. The article first appeared on The Conversation.
