Healthy habits of centenarians reveal four things that can increase longevity

In the current era and as a result of several factors people live longer than before and we can expect to see more people reach the age of 100 in the coming years. The number of centenarians worldwide increased from 151,000 in 2000 to 573,000 in 2021. Centenarians embody successful aging, often suffer fewer chronic diseases and maintain independence in daily life until the age of ninety. Genetic factors contribute to longevity, but modifiable factors make up more than 60% of successful aging.

What factors especially contribute to living to age 100? To find out, we reviewed the lifestyle and healthy habits of centenarians and those about to reach the age of 100 (ages 95-99) around the world. Our last review included 34 control studies published since 2000. Here are four key factors that we found to contribute to longevity.

1. A varied diet with controlled salt intake

Centenarians and those about to reach the age of 100 followed a balanced and varied diet. On average, we found that they get between 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. Their diets included staple foods (such as rice and wheat), fruits and vegetables, and protein-rich foods such as poultry, fish and legumes, with moderate consumption of red meat. This diet, similar to the Mediterranean diet, is associated with a lower risk of impaired bodily function and death. Most centenarians also preferred a low-salt diet. While only one study in our review measured average daily sodium intake, finding 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 Okinawa diet, known for its consumption by Japanese centenarians on the island of Okinawa, contains an estimated 1.1 grams of sodium. We found that eating higher amounts of salt (those who preferred salty food or added extra salt to meals) had a 3.6-fold increased risk of impaired bodily function compared to those who did not prefer salt. In practice, these results suggest that we should include plenty of whole grains, root vegetables, beans, legumes, fruits and vegetables in our diet, reduce the consumption of red meat, choose lean poultry, fish and vegetable protein, and monitor salt in our food.

2. Reduced use of drugs

Perennials are not without chronic diseases, but they usually develop them much later than ordinary adults. More than half of the people in our review experienced common problems such as high blood pressure, dementia, or cognitive impairment. We found that people in our review took an average of 4.6 drugs. The most commonly used medications included blood pressure medications and medications for heart disease non-aged people in this study took 6.7 drugs on average. The fact that centenarians take fewer medications may indicate better health with fewer medical conditions. However, data on drug use are often self-reported and therefore may not be entirely accurate, especially among people with cognitive impairment. There seems to be an association between reduced drug use and living longer. Multiplicity is often defined as taking five or more medications at a time, which is common in older adults. Inappropriate polypsychedalism is associated with an increased risk of adverse events such as falls, cognitive impairment and hospitalization due to adverse drug interactions. While the type or number of medications prescribed may not be under the patient's control, it is important for doctors to prescribe medications only when necessary, fully inform patients about the benefits and risks, and review treatment plans regularly.

3. Get a good sleep

The quality and quantity of sleep affect the immune system, stress hormones, heart function and metabolism such as obesity, high blood pressure, and diabetes. Good sleep is associated with long years of good health and a lower risk of chronic disease. In our review, 68% of centenarians were satisfied with their sleep quality. In a survey of adult sleep satisfaction in 13 countries in 2020, sleep satisfaction ranged from 29% to 67%. The optimal sleep duration is between seven and eight hours a night. Tips for better sleep include maintaining a regular sleep routine, creating a comfortable environment, exercising regularly and managing stress.

4. Living environment

More than 75% of centenarians and those about to turn 100 in our review live 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, health, and well-being. For example, exposure to green spaces has been associated with lower levels of stress, depression, blood pressure, type II diabetes and heart disease, which can lead to increased life expectancy.

Other important factors

We did not consider all lifestyle factors associated with longevity in our review. Research also shows that not smoking, avoiding or drinking alcohol in moderation, staying physically active and maintaining social relationships are important for boosting a person's chances of living to age 100. Of course, adopting the lifestyle changes discussed in this article will not guarantee you reaching the age of 100.  But many older adults are seeking healthier lifestyles to prevent and manage chronic diseases, while healthcare professionals also recognize the value of lifestyle medicine. The sooner you can adopt positive lifestyle changes and healthier habits, the better you will be positioned to achieve a long, healthy life. Reaching the age of one hundred is a lifelong endeavor.