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The nine rules to follow if you want to live to 100
Experts say the ageing process shouldn’t create big problems until your late 90s; here’s how to keep your body young
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In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden – by 2021 the UK was ranked 29th
Life expectancy in the UK has grown at a slower rate than comparable countries over the past seven decades, according to researchers.
A new study, published in the Journal of the Royal Society of Medicine, found that the UK lags behind all other countries in the group of G7 advanced economies except the US.
The researchers said this was partly due to income inequality, which rose considerably in the UK during and after the 1980s.
In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden – by 2021 the UK was ranked 29th.
Between 2018 and 2020 average life expectancy at birth in the UK was 79 years for men and 82.9 years for women, according to the ONS.
However, since 2011 increases in life expectancy have slowed after decades of steady improvement, prompting much debate about the causes. And there is a fear that, while we are living longer, we’re not necessarily living better – spending many years in poor health, unnecessarily.
And yet, science, and some so-called superagers, are showing us that ageing is not as inevitable as we think.
At the ripe old age of 97, Johanna Quaas can still lie on her back and reach her toes over her head to touch the ground behind her.
You can see her do that and other feats of physical fitness on her Instagram page. As far back as 2012 the geriatric German was certified by the Guinness Book of World Records as the world’s oldest active competitive gymnast.
Turning ageing on its head: German gymnast Johanna Quaas is still in amazing shape at 97
Many gerontologists – scientists who study ageing – believe that Quaas is far from being an outlier: it is within all of us to stay just as fit and supple right up to the age of 100. “The science is that the normal biological process of ageing by itself is not a cause of major problems until your late 90s,” explains Sir Muir Gray, a British physician and a director of the Optimal Ageing Programme. “Her Majesty Elizabeth II and Sir David Attenborough are examples of that.”
Some decline in one’s maximum level of ability is inevitable. “Your pulse rate, for example, and your resilience,” says Sir Muir. “Your ability to recover from something such as a trip or fall, or even lockdown.” But science is showing us that many of the hallmarks of ageing aren’t as inevitable as we might think.
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What we eat, how we exercise and our exposure to stress and pollutants all impact the degree to which the functioning of our longevity switches in our body decline. So why does the fitness and health of so many people decline decades before they even come close to the age of 100, while the likes of Quaas keep tumbling and somersaulting?
“The reason is the consequences of 40 years of sitting,” says Sir Muir, 78, who, true to his message, is walking briskly while talking on the phone. “Genetically we were not developed for the environment we live in now. Our genes were designed for us to be running about all the time, and if we managed to catch any food we put on fat as quickly as possible.”
Most diseases, he says, are caused not by ageing but by the environment we live in. “I never use the word ‘lifestyle’ because that implies it’s all free choice but, if you’re commuting from Barking to Vauxhall and sitting for eight hours at a computer, you don’t really have a lot of free choice.”
Sir Muir Gray cites Sir David Attenborough as an example of somebody who has stayed healthy well into their tenth decade
While you need a bit of luck, he adds, to avoid Parkinson’s, Alzheimer’s and some cancers, “most diseases are due to our mismatch with our modern environment”. This is undoubtedly where economic deprivation takes its toll on healthy ageing.
The other factor contributing to premature ageing is social. “It could be deprivation or the effect of negative thinking.”
What’s crucial though is that staving off the ageing process is within all of our powers. And the fight back against ageing need not be arduous, expensive or time consuming. You don’t need to become a bodybuilder or a marathon runner. You don’t need to be able to contort yourself into a pretzel. Being able to get up from the floor unaided is enough.
You certainly don’t need to spend $2 million a year, like 45-year-old Silicon Valley tech mogul Bryan Johnson thinks is necessary in order to turn back the clock. His ultimate goal is to reverse biology and make each of his 78 organs – including his brain, heart, lungs and kidneys – medically 18 years old.
Johnson apparently wakes up at 5am and conducts an hour-long workout with 25 exercises, takes dozens of supplements including creatine, rinses his teeth with tea tree oil and follows a strict vegan diet, eating 1,977 calories per day.
The late Queen, in contrast, walked with her dogs, rode horses, hiked around the grounds of her estates and otherwise stayed active throughout her life and into her old age.
The key to remaining physically active, says Sir Muir, is: “The Five S’s to do with fitness. Four of them are strength, stamina, skill and suppleness. The fifth is psychological,” he laughs.
In his opinion, everyone should try to get more active with every year and each new diagnosis that comes along, “despite the well-meaning intention of people who tell you to sit back and get Ocado to deliver”. As such he orders me to go for a brisk 10-minute walk as soon as our call ends.
Here are the other ways you can keep your body young and function well into “old” age.
Brain
Regular exercise is a key component of maintaining healthy brain function
Regular exercise is a key component of maintaining healthy brain function
You can teach an old dog new tricks, and it’s important to, says Sir Muir. “I was taught as a medical student that after the age of 20 your brain cells die off, but as we now know you can forge new circuits between brain cells at any age,” he says. Lifelong learning will promote stronger brain function in old age, as a study by the University of Zurich discovered.
Researchers examined the brains of hundreds of older adults, and discovered that those with an academic background showed far fewer signs of brain degeneration over the course of seven years.
Similarly, having close ties to friends and family, and participating in meaningful social activities, has been linked to helping maintain thinking skills better in later life and slowing down cognitive decline.
Walking can also stave off brain ageing. A study published last year by the University of California suggested that regular exercise – of 150 minutes a week or more – could go a long way to arresting brain-function decline. The researchers found that exercise keeps the brain young by producing synaptic proteins, which enhance the connections between brain cells.
Good sleep (integral to clearing beta-amyloid, associated with Alzheimer’s, from the brain), minimal stress (keeping inflammation lower), following a Mediterranean diet (DHA is important for brain function) and physical activity are all key factors we can control: “Keeping healthy brain tissue is about keeping that blood flowing to the brain. Challenging yourself, having a sense of purpose and engaging with others are all integral to brain function,” says Sir Muir.
Heart
Lifting weights has been shown to help keep the heart healthy
Many people assume their risk of heart disease is inherited. “Which is true to an extent,” says Helen Alexander, Nuffield Health’s physiotherapy manager and cardiac rehabilitation lead. “But there are many changes you can make to reduce your risk of developing heart disease as you get older.”
The same risk factors apply for diabetes and chronic kidney disease, she adds.
The most important thing is to reduce your sedentary time. Regular exercise will make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level. “Try sitting for less than 50 per cent of your waking hours. Try to be on your feet every hour. Take the stairs, get off the bus one stop early, incorporate physical activity into your everyday life,” says Alexander.
You don’t need to be signing up for a half marathon. Aerobic exercise that will benefit your heart should be moderate: “Movement that makes you warm and comfortably breathless,” she says.
You should also build in resistance and strength training. “We know now that both are equally important.” A study by Iowa State University found that regular strength training lowered the risk of high blood pressure by 32 per cent and decreased the chance of developing metabolic syndrome, which increased the risk of heart attack by 29 per cent.
Alexander recommends strength training two or three times a week. Lifting weights or body weight exercises, such as squats, will help maintain muscle mass and contribute to your overall physical fitness. “As well as helping you avoid heart disease, this will help avoid stroke as well,” says Alexander.
Diet also plays a crucial role in risk factors for heart disease. A study by the University of Athens found that the incidence of heart attack, stroke and irregular heart rhythm increased as ultra-processed food consumption rose. “Following a Mediterranean diet is important for cardiovascular health,” says Sir Muir.
Teeth
Within 20 seconds of consuming sugar, it combines with the bacteria hanging out in your mouth to form an acid that starts to damage your teeth
Within 20 seconds of consuming sugar, it combines with the bacteria hanging out in your mouth to form an acid that starts to damage your teeth
Dentures might once have seemed inevitable, however by looking after our teeth they can run the course of our lives right alongside us.
The best way to help your natural teeth last as long as possible, says Dr Martina Hodgson, dentist at thedentalarchitect.com, is to “adopt a twice-daily cleaning routine, floss at night, avoid sugary food and drinks whenever possible and ensure you have a dental check-up twice yearly to catch any potential issues before they become major problems”.
Within 20 seconds of consuming sugar, it combines with the bacteria hanging out in your mouth to form an acid that starts to damage your teeth. As time goes on, this wears away at the layers in your enamel, eventually resulting in a cavity. As we age our gum health becomes an important consideration, says Sir Muir.
Poor oral hygiene can cause receding gums because of plaque building up into tartar. Tartar breeds disease-causing bacteria which affect the gums, causing them to recede towards the tooth root.
“People should go to the dental hygienist more often as they get older, at least twice a year, and should use an electric toothbrush,” says Sir Muir.
Lungs
Breathing deeply and getting out of breath can help to boost lung health over time
Whether it’s through music or exercise, breathing deeply helps to boost lung health over time
If you’ve tried and failed to give up smoking, “then try again,” says Sir Muir. The chemicals in tobacco smoke damage the delicate lining of the lungs and can cause permanent damage that reduces the ability of the lungs to exchange air efficiently.
Air pollution is an increasing issue. Asthma, COPD, lung cancer and respiratory infections all seem to be exacerbated due to exposure to a variety of environmental air pollutants with the greatest effects due to particulate matter (PM), ozone and nitrogen oxides. “My lungs are a bit damaged as I grew up in Glasgow before the Clean Air Act,” says Sir Muir.
The good news is that brisk walking can help. When you exercise and your muscles work harder, your body uses more oxygen and produces more carbon dioxide. To cope with this extra demand, your breathing has to increase from about 15 times a minute (12 litres of air) when you are resting, up to about 40–60 times a minute (100 litres of air) during exercise.
Your circulation also speeds up to take the oxygen to the muscles so that they can keep moving. “It makes your muscles better at extracting oxygen from the blood. Increasing your stamina by any form of exercise that makes you breathe a little quickly will help the whole respiratory system,” says Sir Muir.
Skin
Clear and bright: the late Queen had beautiful skin
Elizabeth II was known for her beautiful skin into old age: “It probably had something to do with always spending the summer in Scotland,” laughs Sir Muir.
The sun is the biggest culprit for premature ageing, mainly due to UVA rays. Exposure to UV light breaks down your skin’s connective tissue – collagen and elastin fibres, which lie in the deeper layer of skin (dermis).
“The biggest and best investment you can make is a good broad spectrum sunscreen from an early age,” says Dr Zoya Awan, medical director at Secret Aesthetics.
“Sunscreen does not reverse the signs of ageing skin but it is the most powerful preventative measure in the fight against ageing skin.”
As we age it’s also important to get any suspicious moles checked out. “Keep an eye out for any changes, such as brown spots on your skin which could be melanomas,” says Sir Muir.
Bones and joints
Yoga and pilates can do wonder for joint health
You might think that knee and hip replacements are inevitable, but they are the result of our environment rather than our genetics. The most important things to do to ensure you reach old age with healthy bones and joints is to “keep active, keep your weight down and focus on suppleness the longer you live,” says Sir Muir.
Activities such as tai chi, yoga and pilates are recommended.
You might think that losing an inch in the spine is inevitable as you age, but, says Sir Muir: “While there’s a little bit of bone loss, it’s mostly the effect of 50 years of sitting.”
When we’re younger we might enjoy high-intensity exercise but “a brisk walk is better than a jog at any age”, he says.
He cites the knee and hip injuries of tennis players such as Roger Federer and Andy Murray as being “industrial injuries from playing tennis at a high level, running from one side of the court to another”.
Our ancestors may have had to run away from a sabre-toothed tiger occasionally, “but not every two minutes for four hours, five times a week, which is what tennis players do”.
Focusing on lower intensity activities such as cycling and swimming is advisable for protecting knees and hips in the long term.
And Sir Muir adds: “It’s never too late to increase suppleness. Most damage is to the soft tissue rather than bone. It’s important to keep moving even if you have joint pain.”
Helen Alexander adds: “Evidence shows that being active maintains the lubrication of joints and the strength of the muscles that surround those joints.”
As we get older some reduction in muscle mass and bone density is natural, however if you maintain physical activity, it can be minimised “and therefore reduce your risk of falls and fractures”, says Alexander. “Start with small doses and build up slowly, which means you’re less likely to be injured.”
Hands
Stretching hands can help keep them supple over time
They are the tools with which we interact with the world. “Keeping the muscles of the hands strong by using them every day is important,” says Maxim Horwitz, a consultant orthopaedic hand and wrist surgeon in the Hand Unit at Chelsea and Westminster Hospital and founder of the Hand Doctor Practice.
“The joints and muscles of the hands are like other parts of the body and will wear out with time, but having a healthy diet with food that includes fish oils has been shown to protect joints.”
Eyes
Eye-friendly nutrients can be found in fruit and vegetables such as spinach, red peppers, kale, leeks, avocado, peaches and blueberries
They are our windows onto the world, but can become less clear as we age.
The lenses of the eyes become less flexible as we get older, making it difficult to focus on close objects – a condition called presbyopia – while age-related macular degeneration (AMD) makes the middle part of your vision blurred or distorted.
Eye-friendly nutrients found in fruit and vegetables such as spinach, red peppers, kale, leeks, avocado, peaches and blueberries can help to protect against AMD, while recent research has shown that eating fish once a week can reduce your risk of developing early AMD by up to 40 per cent.
Cataracts are when the eye’s lens develops cloudy patches, which become bigger over time causing blurry vision and eventual blindness. “It may be that cataracts are due to artificial light, but there’s not much we can do but get our eyes checked on a regular basis,” says Sir Muir.
While getting a screen break is never a bad idea, he adds: “Better always to leave your desk entirely and go for a brisk walk than to try some eye exercises.”
Growing scientific evidence suggests that aerobic exercise can increase crucial oxygen supplies to the optic nerve and lower pressure in the eye.
Feet
Taking care of unruly toenails and visiting a podiatrist are recommended for optimum foot care
With age comes natural changes in the elasticity and stability of tendons and ligaments, along with aches and pains, bunions and clawing toes.
Once you’re over the age of 60, visiting a podiatrist can be a wonderful thing, says Sir Muir. “They can help you with thickening nails and other things you might not be able to reach so that you can keep your feet healthy.”
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