How to Live to Be 90

This will be a short(ish) post, but I thought it would be cool to do an overview of a recent study published in the British Journal of Medicine. Title: “Body Size, non-occupational physical activity, and the chance of reaching longevity in men and women: findings from the Netherlands cohort study.” Quite the mouthful.

I find this study interesting due to the ongoing debate as to which lifestyle factors are most contributing to long and healthy lives. Many in the longevity field are concerned with how best to reach old age. Nobody seems to have the answer, and all we can do really is study the habits centenarians (those who live to be 100) and other old-aged (i.e. 90+) individuals.

This has been done, but, if you’ve been paying attention to the news, you may have heard that the world’s oldest World War II veteran recently died in December at 112 years of age. His secret was whiskey, cigars, and ice cream — daily. So much for healthy habits.

Anyways. Studies like the one I’m about to talk about provide some insight into what large groups of long-lived people are doing — things like exercise and maintaining a healthy body weight. Perhaps, the thinking goes, this might give us insight into what we can do NOW to increase our odds of living as long as they have.

The Netherlands Cohort Study (NLCS) is a prospective cohort study; meaning that participants were gathered at baseline (1986), had some physiology and biometric data collected, and have been followed up ever since then. The idea of these studies is to see how certain traits change over time and how they influence an outcome, like age or disease rate.

This study sought to determine an association between height, dimensions of body mass index (BMI), non-occupational physical activity (e.g. exercise) and the chance of reaching longevity. Longevity here is defined as reaching the age of 90.

What did they measure? Everyone in the study had a measure of height, weight, weight at 20 years of age, and levels of non-occupational physical activity. Each participant was categorized into a BMI category at baseline and at 20 years. Interestingly, they also calculated the “change in BMI” from age 20 to baseline.

To figure out physical activity; participants were asked to report how many minutes they spent per day in things like walking/cycling to work, going shopping, walking the dog, and how many hours of leisure time they spent per week in recreational activities like walking/cycling, gardening/chores, and playing sports or gymnastics. Using this self reported data (which I’m always wary of…), a total could be calculated for, on average how many minutes/day each person spent in physical activity.


There were a total of 433 men (16.7% of the total) and 994 women (34.4%) in the cohort studied survived until the ripe age of 90.

Broken down by sex. The long-lived males were shown to spend more time in non-occupational physical activity than the shorter lived group (known as “non-survivors” in this paper).

Regression curve for the association of height, BMI at baseline, change in BMI since age 20, and non-occupational physical activity with the chance of reaching longevity (age 90) in men and women separately.

The women survivors were, on average, taller, had a slightly lower body mass index (BMI) at baseline, and had a lower increase in BMI since the age of 20, as well as higher physical activity levels than the females who didn’t live to be 90.

All good and well, but we want to know, how much physical activity did these long-lived people do? How much did they weigh, and how tall were they?

The Women

Women who were taller than 175 centimeters had an increased chance to reach longevity vs. those shorter than 160 cm. Being obese was a risk factor for not reaching longevity; the women who had a BMI >30 and those who gained over 8 kg/m2 in BMI after the age of 20 had reduced chances of getting to 90 years old.

What about physical activity? More (to a point) is better. Women reporting greater than 30–60 min/day of physical activity had better chances of living until 90 than women who got less than 30 minutes per day. The highest chance of a long-life occurred in those who got around 60 minutes per day.

The Men

Surprisingly, the same associations seen in women weren’t present in men — neitherheight, BMI at baseline, BMI at 20 years of age, nor change in BMI since at 20 seemed to significantly influence longevity. In neither group did BMI at age 20 seem to influence longevity; it seems like it’s all about what happens after this stage…

Men who workout more live longer. In this study, >90 minutes of physical activity per day was associated with a greater chance of longevity compared to less than 30 minutes per day. Each additional 30 minutes per day increased the association.

What does this study tell us? Does it give us the “secret” to longevity?

Perhaps not, but it does provide some sex-specific data on lifestyle-related factors that may account for a long live.

How to live to age 90

Many of the factors important for longevity in this study were different based on the participant’s sex (no surprise here).

If you’re a woman — it may be better to be tall (over 175 cm), but this probably tells us little. Height is influenced by a ton of socioeconomic and nutritionrelated factors early in life, which might confound this.

Don’t be overweight, and don’t gain a lot of weight between age 20 and age 70 — both of these were associated with lower chances of longevity!

Exercise for about 60 minutes a day. A U-shaped relationship for physical activity and longevity was found in women — so lower and higher levels actually lowered the chance of living long.

If you’re a man — height, BMI, and gaining weight didn’t seem to matter. Why this was found to be the case is unclear, I guess we need more studies.

Exercise, for as long as you can. There didn’t seem to be an “upper limit” for physical activity duration in men like there was in women. Those who had higher physical activity had greater odds of living to be 90.

This interesting study is just another addition to the prospective studies on long-lived individuals, each providing us with little takeaway nuggets about what the super-agers do to live healthy and long.


Brandts L, Van den brandt PA. Body size, non-occupational physical activity and the chance of reaching longevity in men and women: findings from the Netherlands Cohort Study. J Epidemiol Community Health. 2019;73(3):239–249.

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