Many of us are fascinated by stories of unusual longevity.  It seems every television network has some variation of a segment celebrating birthdays at or around 100 years old.  Perhaps it is because those over the century mark are one of the fastest growing segments of the United States population.  So often, getting to triple digits, living longer, and being the oldest kid on the block seems to be our obsession.  We like thinking about how long we want to live, rather than how well we want to live.  Is there a way to do both – live well, and live long?

 For years, medical researchers have studied centenarians; those one hundred years or older, to identify clues to longer life.  What seems clear is that longevity is not merely a chance event dependent on good genes, although longevity does run in families.[1]   A landmark Swedish study of identical and fraternal twins reared separately has provided much of the data regarding the relative influences of nature versus nurture in the components of aging.  Generally it is agreed that genes only account for approximately 20-30% and environment 70-80%.  This idea is supported by a study of Seventh Day Adventists at Loma Linda University who as a group have perhaps the longest average life expectancy in the United States, 88 years for men and 89 years for women. The main attributes that these individuals have in common is that their religion for the most part asks that they make very good lifestyle choices. That is, they tend to be vegetarian, they don’t smoke, they regularly exercise and they spend a lot of time with their families and with their religion. Many Americans do the opposite and thus it is not surprising that on average, Americans die 8-10 years sooner.

 But is a longer life worth living if you become frail, demented and dependent?  The vast majority would answer unequivocally, “no”.  Interestingly, studies of centenarians have uncovered some surprising facts.  The New England Centenarian Study dispelled the misconception that the older you get, the sicker you become.[2]  Lead author, Thomas Perls says, “the older you get, the health­ier you’ve been.”   In other words, peo­ple who demon­strate excep­tional longevity tend to have had a life­long his­tory of good health.  Indeed, peo­ple who die in their 70s or 80s are plagued by degen­er­a­tive ill­nesses in the years before their death; in con­trast, Perls has found that nearly two thirds of cen­te­nar­i­ans either delay the onset of dis­eases such as heart dis­ease, stroke, and diabetes—or escape them alto­gether. Plus, a sub­stan­tial pro­por­tion of cen­te­nar­i­ans who sur­vive such age-related ill­nesses do so with­out devel­op­ing phys­i­cal dis­abil­i­ties, enabling them to remain socially, men­tally, and phys­i­cally active. 

 It is apparent that living to 100 confers an important advantage in years of healthy living.  Not all centenarians are identical but there are a number of common characteristics:

  • Few centenarians are obese. In the case of men, they are nearly always lean.
  • Substantial smoking history is rare.
  • Centenarians are better able to handle stress than the majority of people.
  • Nearly 1 in 5 centenarians had no significant changes in their thinking abilities disproving the expectation by many that all centenarians would be demented.[3]
  • Alzheimer’s disease was not inevitable.  Some centenarians had very healthy appearing brains with neuropathological study.[4]
  • Many centenarian women have a history of bearing children after the age of 35 years and even 40 years, suggesting optimal hormone balance plays a role.

Biologically, telomere length correlates with years of healthy living.[5]  Telomeres are part of your chromosome that acts as a biologic clock.  As you age, and each time your cells divide, your telomeres get shorter.  When they get too short, your cells stop dividing and die.  This is the biological basis of aging.[6]  But if the enzyme telomerase is activated, it can repair and build telomeres, slowing the aging of your cells.  In a study of centenarians, those classified as healthy (being physically functionally independent without hypertension, heart failure, heart attacks, peripheral vascular disease, dementia, cancer, stroke, chronic obstructive lung disease and diabetes) had significantly longer telomeres than their unhealthy peers.[7] Obese individuals have shorter telomeres than their same age counterparts, and obesity increases the risk for several degenerative diseases and premature death.  Chronic perceived stress can shorten lifespan and increase your risk of degenerative disease associated with aging.[8]

How can you get longer telomeres?  A healthy plant-based diet combined with regular physical activity has been shown to increase telomerase activity by 30%.[9]  Fish oil supplements[10] and regular multivitamin use have both been associated with improved telomere maintenance.  Regular, vigorous exercise activates the telomerase enzyme, improves cardiorespiratory fitness and reduces the risk of several degenerative diseases.  In one study, sedentary individuals had telomere shortening equivalent to 10 additional years of aging compared to those performing an average of 28 minutes per day of physical activity.[11] 

It seems more than coincidental that the same healthy lifestyle choices that are common among healthy centenarians are the same choices that preserve telomere length on a biological level.   But what can improve your odds of making sustainable lifestyle choices?  It is not just disease-risk modification or the fear of death.  It is the joy of living; and living well.  Pleasure, joy and freedom beat out willpower, deprivation and austerity.   Devel­op­ing healthy habits and a pos­i­tive atti­tude towards life while we’re young, though chal­leng­ing at times, can set us up to be happy, healthy, and inde­pen­dent in old age.  Although many of us do not think about it until we are old, aging well isn’t just a project for the elderly. It’s some­thing we need to work toward our entire lives.  Why not start living better today?

[1] Perls T, Kunkel L, Puca A. The Genetics of Exceptional Human Longevity. J Am Geriatr Soc 2002;50:359-368

[2] Perls TT, Bochen K, Freeman M, Alpert L, Silver MH. The New England Centenarian Study: validity of reported age and prevalence of centenarians in an eight town sample. Age and Ageing.1999;28(2):193-197

[3] Silver, M.H., Jilinskaia, E., Perls, T.T. Cognitive functional status of age-confirmed centenarians in a population-based study. Journal of Gerontology, Psychol Sci 2001;56B:P134-P140

[4] Silver MH, Newell K, Brady C, Hedley-Whyte ET, Perls TT. Distinguishing between neurodegenerative disease and disease-free aging: correlating neuropsychological evaluations and neuropathological studies in centenarians. Psychosomatic Medicine 2002;64:493-501.

[5] Njajou, O. T. et al. Association between telomere length, specific causes of death, and years of healthy life in health, aging, and body composition, a population-based cohort study. J. Gerontol. A 64, 860–864 (2009).

[6] Mikhelson, VM, Gamalei IA, “Telomere shortening is the main mechanism of natural and radiation aging” Radiats. Biol. Radioecol. June 2010;50(3):269-75

[7] Terry D, Nolan V, Anderson S, et al. Association of longer telomeres and better health in centenarians. Journal of Gerontology: Biological Sciences 2008 63A:8:809-812

[8] Epel, E. S. et al. Accelerated telomere shortening in response to life stress. Proc. Natl Acad.Sci. USA 101, 17312–17315 (2004).

[9] Ornish D, Lin J, et al. Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncol. 2008;9(11): 1048-1057

[10] Farzenah-Far R, et al, “Association of Marine Omega-3 Fatty Acid Levels With Telomeric Aging in Patients With Coronary Heart Disease” JAMA. 2010;303(3):250-257 (doi:10.1001/jama.2009.2008)

[11] Cherkas L, et al. The Association between Physical Activity in Leisure Time and Leukocyte Telomere Length.  Arch Int Med 2008; 168 (2)