How to live to 100 by Dr Vania Sinovich

The science of longevity is revealing the secrets of how to make extra years as healthy and happy as possible. The biological traits associated with extreme longevity are about 30 percent heritable. While our genes are out of our control, habits and lifestyles can extend our lives by decades. Harnessing your diet, exercise and mindset can help you achieve this.

What to eat and microbiome

The typical Western diet is not optimal for longevity - high in refined grains, added sugars, red and processed meats and dairy products and low in whole grains, fresh fruit, vegetables, nuts and fish. In fact it is responsible for 11 million premature deaths a year.

Last year a deep dive into the dietary habits of thousands of people age 95 and over still living in the community across Asia, Australia and Western Europe revealed a diet rich in fruit, vegetables, white meat, fish, legumes, minimal alcohol and low salt. High salt consumption is a causal factor in cardiovascular disease, the world’s biggest killer.Healthy ageing, defined as reaching 70 free from major chronic disease, as well as being physically fit and mentally sharp, found that diet was key. The majority of subjects had stuck to a healthy Mediterranean-style diet throughout middle age. Those who binged on fatty, salty and meaty foods, on the other hand, rarely aged well.

Longevity isn’t just about what you eat but also how much. Most people aged 95 and over were typically slim - either normal weight or underweight. Obesity is not a prescription for making it to 100. 

Calorie restriction, which has been shown to extend the lifespan of laboratory animals by restricting their preferred category intake by 25 percent or more, has not yet been proven to work in humans. Actually being underweight by 25 percent worsened the ability of participants to carry out basic daily living activities. It seems normal body weight is ideal. 

Meanwhile, taking care of your microbiome is also key. Microbial activity affects many biological pathways associated with ageing including those in mitochondria, metabolism and the immune system. It might help to think of yourself as a collective of human cells plus trillions of microbes that live in and on you. It is not just our cells that change with age; our microbiome transforms too. Increasingly, researchers are showing that our friendly and not so friendly bacteria lie at the core of healthy ageing. Nurturing them may be a smart way to live healthier and longer. The greater the diversity of gut microbes, the healthier you tend to be.

Unfortunately, as we age our microbiome changes often show a decreased abundance of healthy bacteria. Older adults tend to eat less diverse diets, take more medication and have fewer social interactions, all of which have a knock-on effect on the type of microbes living in the gut. Researchers have focused on microbes that produce short chain fatty acids (SCFA) through the fermentation of dietary fibres. Short chain fatty acids are involved in maintaining the cells in our gut lining and suppressing inflammation, regulating the immune system‘s response to pathogens and controlling blood sugar levels. As we age, the number of microbes making short chain fatty acids reduce while the pro-inflammatory ones increase. This imbalance is thought to contribute to low grade inflammation, a state known as inflammaging which is associated with high risk of cardiovascular disease, dementia and stroke.

A study looking at 1,575 people aged between 20 and 117 in China showed that compared with adults aged 66 to 85, the gut microbial signature of those aged 100 to 117 was more similar to that of young people with higher diversity and greater abundance of beneficial bacteria. This raises the question of whether we can nurture our microbiome to age better. Prebiotics are supplements which provide food for helpful gut microbes and probiotics are gut friendly microbes that you can take as a supplement. Studies on prebiotics (typically sponsored by nutrition companies) are limited but promising. Dietary changes may be just as effective. When older adults across several countries adopted a Mediterranean diet for one year, those who adhered most closely retained more microbial diversity and boosted gut microbes linked with healthy ageing. This correlated with improvements in their health such as better walking speed, strength and memory.

We can add 10 years to our lifespan by switching to a diet mostly of whole grains, fruit, vegetables, nuts, legumes, and fish. Meanwhile, we are just beginning to explore how we might manipulate our microbes through diet, drugs or even gene editing technologies.

Exercises that will help you live longer

Lack of physical activity has been linked to at least 3.9 million premature deaths globally a year. It significantly increases the risk of chronic illnesses including heart disease and some cancers. Getting enough exercise can add up to seven years to your life while also extending the time you spend in good health. The world’s oldest people typically report a lifetime of regular moderate exercise such as walking, farming and gardening. Moderate exercise results in a surge of internal maintenance and repair. If we don’t move, our bodies save energy by letting the function of maintenance and repair slide. Because of the ‘use it or lose it’ aspect of this, exercise is one of the strategies we can adopt in order to optimise the rate with which we decline.

 World Health Organisation guidelines offer some specifics. Ideally adults should do at least 150 to 300 minutes of moderate intensity physical exercise a week - exercise that leaves you able to talk but not sing. This might include brisk walking or 75 to 150 minutes at vigorous intensity - running or cycling in heavy terrain, which leaves you breathing hard and fast - plus strength training done at least two days a week. For people age 65 or over, includean extra strength session and add balance and mobility exercises. Multiple workouts are just as effective as longer more structured ones.

From middle age onwards, everyone should get serious about working on muscle strength. From our 30s on, muscle mass starts to decline, with the first twitch muscle fibres - those needed to stand up for a chair, for example - taking the biggest hit. Multiple studies have shown a link between weak hand grip strength and a shorter lifespan. Grip strength is a good indicator of overall muscle strength, correlating with the strength in the major muscle groups, particularly the legs.

Balance work from middle age onwards is also a good idea. A study in 2022 shows people between age 51 to 55 who couldn’t balance on one leg for 10 seconds were twice as likely to die within the following 10 years. Squats and planks are a good place to start and as we age, increasing the load by adding weights or using resistance bands. Power training, like doing fast leg presses in the gym at 80 percent of the maximum weight a person can lift, is good because more explosive strength training builds up fast twitch type II muscle fibres, which are the first to be lost during ageing.

It’s never too late to start. Power and strength training have helped even frail people in their 90s build muscle that improves their ability to stand and walk independently.

Nurture the right mindset

The most important thing is to get involved - interact with other people, have a purpose, get up and move and be part of the world - as said by 86-year-old Elaine Neuwirth on TikTok.

Social ties are a powerful predictor of late-life health and well-being. Studies show that men who have more positive social relationships and are more involved with their community during mid-life have a low risk of depression and better cognition in late life. People help us figure out solutions to our problems. They help us regulate difficult emotions. Just being near people calms the body in important ways. This is because close relationships positively affect our hormones, our immune systems and even how our genes are expressed. When people are in good relationships, their wounds literally heal quicker. Having more close friends is associated with a strong immune system in general and a greater proportion of cells that delay immune ageing - suggesting that sociability can help make the immune system more potent and useful.

Having close friendships also appears to alter the activity of genes responsible for cellular ageing and several of the systems that help our bodies cope with stress. And since chronic stress is a known driver of heart disease, Alzheimer’s and many other conditions, these effects can be significant over the long run. Analysis of 148 different studies of links between social connectivity and longevity found a 50 percent greater likelihood of survival for participants with strong social relationships. Larger networks are associated with better health. A useful test is to ask yourself who you would call if you woke up sick or scared at night? If no one comes to mind, you may be at risk of loneliness - a driver for depression, heart disease and cognitive decline. Loneliness is so bad for health that its influence on early death is greater than that of obesity. The emotional pain resulting from loneliness can produce the same stress response as a chronic medical condition and thus lead to chronic inflammation and reduced immunity. This is why enhancing a sense of community can be so important while ageing. Find a way to contribute to someone else’s life and let them contribute to yours.

In addition, purpose gives your life direction and makes it meaningful. Having purpose is associated with reduced risk of chronic disease and overall mortality. This is thought to be due to a lowering of stress levels and motivating people to exhibit healthier behaviours. A study in 2022 in Canada that analysed 13,000 United States adults over 50 found that participants who had a sense of purpose had higher physical activity, fewer sleep problems and a reduced risk of stroke and overall mortality. A 2022 study of 14,00O United States adults over age 50 found that those who felt most positive about ageing had a 43 percent lower risk of dying of any cause over four years compared to those who felt least positive about ageing.

A healthy life was always going to require effort. Alongside diet and exercise, remember to nurture your psychological well-being. Call a friend, embrace ageing and reflect on what is truly valuable.

Supporting skin health 

Of course I need to mention skin, with a gentle reminder that 80-90% of skin ageing is due to the effects of ultraviolet radiation, known as photoaging. With summer here, remember the importance of sun protection measures - daily high SPF 50+ broad spectrum sunscreen, protective clothing, avoiding midday sun, seeking shade and eye protection. Daily topical antioxidants in the form of topical vitamin A, B and C help mop up the free radicals, reducing oxidative stresses in your skin and keeping you looking good while enjoying your longer health span. 

At The Skin Company, our dermatologist-led team is proud to remain at the forefront of research and offer you therapies that have been shown to both preserve and rejuvenate you. We offer well researched skin care, AHA, BHA and retinol peels, LED light therapy, Botox, carefully chosen filler, skin needling with the FDA approved skin pen, exosomes, biostimulants (Rejuran, Profhilo classic and Structura), BBL as well as Moxi, vascular, CO2 and hair removal laser to keep you putting your best you forward.