Living to 100 Is Still the Exception, Not the Norm

An October 2024 article in the New York Times about longevity for most people in the U.S. in the coming years predicts that humans may have reached their peak of life expectancy. And the few outliers who lived to be 100 and more are by far the exception and not the norm. So living to be 100 years is still a pipe dream for most people, but what would it take to live for a century?

That article was precipitated by a study in the journal Nature Aging written by S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois at Chicago which said that maximum expectancy in the coming years will reach an average age of 87 in the U.S., 84 for men and 90 for women. So, in essence, life expectancy has peaked.

And yet not everyone agrees with Olshanksy's findings. And some experts like demographer James Vaupel predicted in the article that more children born in this generation will be living until 100 years.

Asked in a follow-up interview with Next Avenue why people can't live on average until 100, Olshansky emphasized that "We're making ourselves live longer but can't avoid the immutable biological process of aging." He compares the aging process to driving an automobile up a steep hill. "The hill gets steeper and the engine stays the same," he said.

Olshansky noted that human body parts wear down and that includes knees and hips, eyes and ears and the cardiovascular system. All of those body parts work efficiently for years (until they don't), and medicine has done an effective job of repairing them. Hence, we get stents for the cardiovascular system, statins for cholesterol levels and drugs for diabetes.

Therefore, he advised it's best to concentrate on the "parts that make us more frail and disabled. The aging brain is one of our most important Achilles' heels, but body parts involved in blood flow and respiration are foundational."

"Most bodies can't last until 100. It's like asking why can't you drive a car for a million miles?" he said.

But Steven Austad, a professor of biology at the University of Alabama at Birmingham, who has studied life expectancy and is also quoted in that New York Times article, said what underlies life expectancy not rising in the U.S. is "because of the way we do medicine. We don't have health care; we have sick care."

In the U.S., physicians wait until a patient contracts a disease and then figure out how to treat it, he indicated, but instead the emphasis should target how to keep people healthy and prevent disease, not treat it afterwards. Doctors, in fact, get reimbursed by health care systems for treating illnesses after they happen, not before.

In fact, Austad projects that a number of medical breakthroughs are on the horizon that "manipulate the aging process and push all the diseases that degrade us." He also points out that we've found "several ways to extend the life of animals through diets, drugs, genetic manipulation," some of which could be transferred into extending human life.

Specifically, he points to a drug rapamycin that in laboratory mice "extends life, reduces cancer and dementia, improves immune function and maintains muscle mass."  And he added that it works with mice that are the equivalent of 60 to 70 years. It's now in an early phase development stage for humans.

Austad also cited that since 2000, deaths from cancer have fallen 20% because of earlier diagnosis, better treatment and immunology; death rates from heart disease and strokes have declined 30% because physicians know how to control blood pressure and cholesterol. Despite these breakthroughs, life expectancy has increased only about two years. 

This lack of increasing life expectancy, he suggested, is "due to the multiple health problems most people face in later life. If one thing doesn't get you, something else will." In fact,  Alzheimer's Disease cases have skyrocketed since 2000.

Restricted diets, where people eat between 9 a.m. and 5 p.m. or 10 a.m. and 6 p.m. have also showed early signs of success as has people fasting twice a week because "DNA gets repaired better," Austad noted. He says these diets trigger "fasting physiology that causes the body to go into 'protective' mode after a period of food deprivation."

Moreover, DNA factors play a crucial role that can transcend people's individual habits. "Choose parents who live a long life," Olshansky recommended as one of the best keys of reaching a lengthy life. "You have no chance of living until 100 unless you own the genetics lottery," he added.

Women live longer for a variety of reasons including hormonal differences — they also carry the next generation, so for evolutionary reasons they need to be protected for a longer time period, he suggested.

Asked what recommendations he'd offer a teenager today whose mission is to live a century, Olshansky replied: 1) Avoid the risk factors that shorten life such as don't smoke, don't drink excessively, avoid excessive sun exposure, 2) Control what you can in terms of exercising and eating a healthy diet, 3) Monitor your behavior by seeking professional help, including going for annual physicals, seeing dentists and eye doctors. 4) Austad adds get plenty of sleep and keep your eyes peeled for the emerging science of longevity.

For people 60 and over who strive to reach 100, many of those same factors come into play, but Olshansky added visiting a primary care physician, cardiologist, skin doctor, dentist and eye doctor and taking their recommendations seriously "increase your chances of living a longer life. If they prescribe medicines, take them."

To increase his own chances of living a long a life, Olshansky goes for a daily 5-mile walk (he used to run marathons), follows a strict diet, avoids consuming fried foods, eliminates sugar from his diet, no soft drinks or artificial sweeteners, takes vitamin D, and follows his doctor's recommendations. Exercising regularly affects a person "physically and mentally" and has countless benefits, though it's still not a guarantee to live to be 100, he suggested.

He's also skeptical of many of the physicians' claims that more people will be living until 100 in the coming years. Most, he says, are trying to "sell you something, including anti-aging medicine."  Asked why so many people cling to the low probability of making it to that triple-digit age, Olshansky said, "They don't want to die and they've been promised a century by people selling them something they wanted to hear."

Living to 100 entails paying close attention to your health, Austad noted, including keeping your weight down, blood pressure and blood sugar low. But don't wait until you're sick to see a physician; instead get involved in a whole new revolution of the health care system and focus on preventing yourself from being sick, staying one step ahead of illness, going for annual physicals (early detection of cancer is often key to survival), focusing on being healthy and minimizing chances of getting cancer or heart disease.

Living to 100 "is going to take all of these lifestyle factors plus luck," Austad said.