What Healthy Centenarians Can Teach Us About Living Longer

Healthy Centenarian

“Take one spoon of apple cider vinegar every day.”

“Take 2 spoons of cod liver oil each morning. “

“Banana’s. They are the key. Eat one every day.”

You’ve heard them all.

Even the recommendations that fly in the face of the medical literature.

“I smoked all my life, and it didn’t do me any harm.”

These are the ‘secrets’ that vigorous 90 and 100-year-olds tell us explain their long and healthy lives.

But let’s unpack things first before we start drinking barrels full of cod liver oil.

First off, what do healthy centenarians actually die from?

Sky diving accidents?

High altitude mountain sickness on their last 8000m ascent?

Or maybe as most of them often hope to die, “being shot in the back by a jealous lover”?

For the most part they die from the same things as everyone else does; cardiovascular disease, cancer and dementia.

The key is they just happen to get these diseases about 20 to 25 years later than everyone else. The longevity research literature describes them as chronic disease survivors or delayers. 

This is very good news.


From a first principles perspective then, living longer becomes primarily about delaying the time of onset of the chronic medical conditions that are most likely to result in our death, rather than focusing on aggressively treating them when they do. We of course do that also.

How do the healthy centenarians do it then?

Easy. They choose their parents wisely.

They win the genetic lottery (In part) and although these genetic advantages do not make them immune to chronic medical conditions, they do provide a body armour of sorts so as they can ‘take more hits’ than us mere mortals before developing the disease.

Additionally, when you evaluate their lifestyle behaviors they are as bad if not worse than all the rest of us when it comes to diet, lifestyle and exercise.

So, when it comes to longevity, do not take their advice, they are none the wiser than any of us.

For the most part. They just happened to get lucky.

If living longer is about delaying the onset of chronic medical conditions and the advice of healthy centenarians is ‘suspect’ to say the least, is there anything we can do to live longer and healthier lives?

The answer is a resounding yes.

It is at this point we need to discuss the difference between possibilities and probabilities.

It is entirely possible that we could all die right now if a sufficiently large asteroid were to hit the Earth.

This is possible.

This is also highly improbable.

Let’s focus on a leading cause of death for most adults, cardiovascular disease.

If you live long enough it’s almost a guarantee that you will develop coronary artery disease.

Given a long enough time horizon then, prevention of coronary artery disease is essentially impossible.

However, prevention of the premature onset of coronary artery disease is highly probable.

The game of longevity then becomes a process of stacking the odds in your favour of delaying the onset of premature coronary artery disease etc.

If you do everything right it is still possible you could develop premature coronary atherosclerosis, but it is highly improbable.

We always need to think in terms of probabilities, not possibilities, just as if we were playing a game of blackjack or poker.

The other poker analogy to consider is that when it comes to the lives we are living; you only get ‘one go on the merry go round’ and you are ‘all in’ whether you like it or not.

This is high stakes gambling and the decisions you make now are going to profoundly influence the probabilities of relevant outcomes in the future.

When you develop coronary atherosclerosis is highly contingent on how you manage the risk factors for the disease. Having a risk factor does not mean you have the disease, but it heavily weights when you will develop it.

The key then has to be about aggressively managing the risk factors for a disease to delay the time of onset. You want to be in camp ‘delayer’ of disease. The evidence for this is overwhelming.

By all accounts then, prevention of coronary artery disease in your 60s is all about the things you do in your 20s, 30s and 40s.

For those who cross the Rubicon of their 50th birthday with a normal cholesterol, as nonsmokers, without diabetes, a blood pressure of less than 120 systolic and a normal BMI will live on average 8 to 11 years longer than someone who had 2 or more of these risk factors at age 50.

That’s a decade of additional life years. As a proportion of your life, that is a very long time.

But try not to think of these years numerically, think of them as experiences you won’t miss; the wedding of child, the birth of a grandchild, a 50th wedding anniversary with the one you love.

These precious experiences would have otherwise been lost.

So, the next time your albeit well- and healthy 100-year-old granny offers you some words of longevity wisdom, be polite and listen, but now you know the truth.



This article was originally published March 3rd 2021 in The Medical Independent

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