5 Key Habits For Longer Healthspans: Dr. Tom Perls (Transcript)

Read the full transcript of Dr. Tom Perls’ talk titled “5 Key Habits For Longer Healthspans” at TEDxBoston 2024 conference.

Listen to the audio version here:

TRANSCRIPT:

DR. TOM PERLS: What if I told you that there was somebody alive today that may live to be 130? Would that intrigue you, or would it scare you? And people living to 100, if you could live to 100, would you want to live that long? Well, today, we’re going to be talking about something that affects all of us, how old we live, but also how old we live well. Imagine it not just reaching 100, but actually doing so active, healthy, and independently towards the end of your very long life.

Speaking of a long life, there’s Jeanne Calment, who was this lady in the south of France who lived to 122 years and 164 days, the world record. Impressively, she did so, living independently to the age of 116. So now we’re going to explore what we can learn from centenarians and those who live to 100 and older, how their stories and biology may hold the keys to living longer and healthier lives.

Defining Lifespan and Life Expectancy

To begin, let’s start with some definitions. Lifespan is the oldest ever member of a species. For humans, that’s Madame Calment who lived to 122. Average life expectancy is the average age at which people die for a population.

Here’s a graph showing average life expectancy over the past 120 or so years. In 1900, average life expectancy was just 46 years. The reason for that was mostly because of infectious diseases at the time, typhoid fever, diphtheria, cholera. Children could expect to live just through childhood about 25% of the time. By the time that we got to 1960, when I was born, average life expectancy was 70. Nowadays, average life expectancy is 85 for women and about 75 for men.

Life Expectancy Disparities

But everybody doesn’t have the same life expectancy. Let me explain a striking example for you. Here in Back Bay, in a well-to-do neighborhood, average life expectancy is 92 years. Go south to Roxbury where average life expectancy is 69 years. That’s a difference of 23 years. And that’s not just a Boston problem. That reflects disparities throughout the country.

For example, in rural Mississippi, rural Alabama, or the Oglala Sioux tribe in South Dakota, those average life expectancies are around 66 years. Go to Marin County in California, average life expectancy is about 85. Here’s a map of average life expectancies in different regions of the country, and red is for average life expectancies of about 67. Blue is average life expectancies of 87, a 20-year difference. You’ll see a concentration of the lower life expectancy in the Southeastern United States and in Native American lands.

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Now what could be the cause of such disparity? Socioeconomic inequality. People in lower income areas face challenges such as poor housing, inadequate education, poor access to health care, poor diet, and much more stress. Systemic racism compounds these disparities, leading to worse outcomes for African American and Native American populations. These are the conditions that shape health and, ultimately, how long we live.

To put it bluntly, where you’re born, how much money you make, and the color of your skin are key determinants of life expectancy in the United States. Curing these social ills is essential, if not more important, than curing heart disease or cancer.

Personal Habits and Life Expectancy

Now what about personal habits? Can the choices we make add years to our lives? Absolutely.

There’s a study in the 2008 Circulation journal that analyzed up to 34 years of health data and mortality data in 120,000 people. That study found that there were five key health habits that seem to play a big role in life expectancy. Those health habits were a Mediterranean diet, two and a half hours a week of exercise, avoiding obesity, not smoking, and having just moderate alcohol use.

Now more surprising, however, is the fact that for people who embrace all five of those habits, they experienced an amazing increase in their life expectancy. Women could expect a 14-year increase in their life expectancy living to the age of 93 if they embrace all five habits. Men could do so experiencing a 12-year increase living to average of 88 years.

Let me show you a little bit more about those numbers. This is a graph showing the number of habits, zero through five, for women and men and the added years that they got with adding each habit. The women who had none of those habits, they had an average life expectancy of 79 years, basically 29 years beyond the age of 50. But if they then had five of those habits, they increase their life expectancy an additional 14 years living to the age of 93, and men showed a similar pattern.

Centenarians and Supercentenarians

Alright. So that’s how you get to 93. What about getting to 100 or 105 or even 110? So centenarians indeed are this remarkable outlier. So for people living to 100, they occurred about one per 3,000 in the population. Living to 110, our supercentenarians are super rare. They’re living at about one per 5 million in the population.

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So how is it that these individuals achieve these incredible ages while most of us do not? Our and others’ research is pointing towards an important role of not just genes, but what we call protective genes. And it isn’t just one magic gene that counts, but rather it seems that there are a couple of hundred genes that in a combination we call protective genetic signatures.

One of the fascinating things about these genetic signatures is that they vary according to ancestry, race, even by family. So it’s important that we enroll as many different backgrounds as possible so we can try and figure out these different signatures that in the end, we think could help us uncover the biological underpinnings of extreme longevity.

Now, unfortunately, we can’t really turn to centenarians to tell us what happened, help us get to 100.

I’ve met centenarians with terrible habits, whether it be eating a lot of meat and sweets or even smoking or even drinking too much alcohol, and they still get to these ages. How do they get away with that? Well, it’s probably because of these protective genes. Even saying that, I find that smoking is very rare in these individuals, so smoking is a nonstarter.

Besides these protective genetic signatures, we do find some other common traits with the centenarians. Many centenarians are socially active. They maintain a sense of purpose well into their late years. These social connections and optimistic mindset may be as important as any specific diet or exercise regimen.

Supercentenarians: The Rarest of the Rare

Now let’s talk about supercentenarians, these incredibly rare people living to 110 and beyond. These individuals are incredibly rare, but they offer some of the most valuable insights into extreme longevity. We’re currently studying about 200 supercentenarians. We think by the time we get 500 supercentenarians, we may be able to start making sense of these exceptional longevity genes, these protective genetic signatures, and their underlying biological pathways that help people get to these extreme ages.

One of the most remarkable supercentenarians in our study was Sarah Knauss. Sarah was the oldest member of our study, living to 119. This is a picture of her with her great-great-great-grandson. Despite her extreme age, just like Madame Calment, she lived the vast majority of that time in exceptionally good health. Understanding what centenarians like Sarah are so resilient could lead to breakthroughs in how we can slow aging and delay the onset of diseases like Alzheimer’s disease.

What’s exciting is that this research isn’t just about living longer. It’s about living healthier. Imagine a world where diseases of aging like Alzheimer’s disease, cancer, heart disease are either greatly delayed or entirely escaped.

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Longevity in Families

There’s another fascinating trait that we’ve noted with the centenarians, and that is longevity runs strongly in certain families. About half of the centenarians that we’ve enrolled in our studies mentioned some longevity elsewhere in the family. If you have a long-lived relative, you may have inherited one of these genetic protective signatures, what we call the longevity jackpot.

Regarding centenarian women, we discovered that many of them were having children in their late thirties or even early forties. When we did the math, we figured out that if you had a child after the age of 40, you had about a five times greater chance of living to 100 compared to women who didn’t. We believe this is because if their reproductive system was aging slowly, so was the rest of them. Having a child at older age is probably one of our best predictors of a woman living to extreme old age.

Conclusion

Now even if you don’t have longevity running in your family, even if you didn’t hit that longevity jackpot, don’t worry because you still can stack the odds in your favor by adapting those five key health behaviors, a Mediterranean diet, exercising, maintaining a healthy weight, not smoking, and drinking in moderation.

Lastly, I want to bring up Jimmy Carter, who’s celebrating his 100th birthday today. He’s frail now, but even in his mid-nineties, he was building homes for the Habitat for Humanity. And he had been doing that for decades. That’s a powerful example of a life well lived, a long meaningful life of purpose.

So that’s what I believe longevity is not just about years. It’s about quality. While many centenarians hold the genetic keys to extreme longevity, we all have the power to unlock a longer, healthier life through our choices, our habits, and perhaps one day even through scientific breakthroughs. So it’s time to decide if you could live your life into your early nineties or even older, healthy and vibrant and independent for the vast majority of that time, would you want to? Because I know the answer for me. I would. Thank you.