Critical review explores longevity determinants in populations, suggesting insights for healthier ageing.
This critical narrative review examines the widespread belief that exceptional longevity can be achieved through simple behavioral "recipes," frequently promoted in media and commercial discourse. Drawing on research in demography, epidemiology, gerontology, and genetics, the article reassesses commonly cited determinants of extreme longevity, including nutrition, physical activity, social environment, psychological resilience, and genetic factors. Emphasis is placed on the analytical value of studying populations characterized by unusually high survival at advanced ages, commonly referred to as "longevity Blue Zones." Whereas studies of individual centenarians provide only limited evidence linking specific behaviors to survival beyond age 100, population-level observation of validated longevity regions offers a complementary and especially informative framework. Analyses of these populations help identify long-term configurations of social, environmental, and behavioral conditions associated with exceptional survival. Recurrent features include lifelong moderate physical activity embedded in daily routines, relatively stable and frugal dietary patterns, dense family and community networks, and culturally embedded mechanisms of stress regulation and meaning. Although none of these factors alone determines extreme longevity, their sustained interaction across the life course appears to increase the probability of surviving to very advanced ages. The review underscores the importance of distinguishing determinants of healthy ageing from those of exceptional survival. Rather than proposing prescriptive formulas, the study of longevity populations provides a population-based observational model for identifying favorable life-course conditions that support extreme longevity. Such insights are valuable for promoting healthier ageing trajectories while acknowledging the multifactorial and probabilistic nature of survival to extreme ages.
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Poulain et al. (2026) studied this question.
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