Tag Archives: centenarian

Centenarian Blood Test Analysis (n=1,754; Part II)

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Centenarian Blood Test Analysis (n=1,754)

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Papers referenced in the video:

Risk Factors For Hyperuricemia In Chinese Centenarians And Near-Centenarians https://pubmed.ncbi.nlm.nih.gov/31908434/

Association between fasting glucose and all-cause mortality according to sex and age: a prospective cohort study https://pubmed.ncbi.nlm.nih.gov/28811570/

Predicting age by mining electronic medical records with deep learning characterizes differences between chronological and physiological age https://pubmed.ncbi.nlm.nih.gov/29113935/

Age and sex variation in serum albumin concentration: an observational study https://pubmed.ncbi.nlm.nih.gov/26071488/

Commonly used clinical chemistry tests as mortality predictors: Results from two large cohort studies https://pubmed.ncbi.nlm.nih.gov/33152050/

The gamma gap predicts 4-year all-cause mortality among nonagenarians and centenarians https://pubmed.ncbi.nlm.nih.gov/29348636/

Triglyceride centenarian studies are referenced in this post from my website: https://michaellustgarten.com/2020/02/19/blood-testing-whats-an-optimal-value-for-triglycerides-2/

Effects of blood triglycerides on cardiovascular and all-cause mortality: a systematic review and meta-analysis of 61 prospective studies https://pubmed.ncbi.nlm.nih.gov/24164719/

High-density lipoprotein cholesterol and all-cause mortality by sex and age: a prospective cohort study among 15.8 million adults https://pubmed.ncbi.nlm.nih.gov/33313654/

Insulin Sensitivity Is A Hallmark Of Longevity

HOMA calculator: https://www.omnicalculator.com/health…

Papers referenced in the video:

Growth hormone-releasing hormone disruption extends lifespan and regulates response to caloric restriction in mice https://pubmed.ncbi.nlm.nih.gov/24175…

Glucose regulation and oxidative stress in healthy centenarians https://pubmed.ncbi.nlm.nih.gov/12543…

Distribution of blood glucose and prevalence of diabetes among centenarians and oldest-old in China: based on the China Hainan Centenarian Cohort Study and China Hainan Oldest-old Cohort Study https://pubmed.ncbi.nlm.nih.gov/32643…

Prevalence and Ethnic Pattern of Diabetes and Prediabetesin China in 2013 https://pubmed.ncbi.nlm.nih.gov/28655…

Families enriched for exceptional longevity also have increased health-span: findings from the long life family study https://pubmed.ncbi.nlm.nih.gov/24350…

High FGF21, Low Insulin And Glucose: A Pro-Longevity Strategy?

Papers referenced in the video:

FGF21 and Chronic Kidney Disease: https://www.sciencedirect.com/science…

The starvation hormone, fibroblast growth factor-21, extends lifespan in mice: https://www.ncbi.nlm.nih.gov/pmc/arti…

Inhibition of growth hormone signaling by the fasting-induced hormone FGF21: https://pubmed.ncbi.nlm.nih.gov/18585…

Alpha-Ketoglutarate, an Endogenous Metabolite, Extends Lifespan and Compresses Morbidity in Aging Mice: https://pubmed.ncbi.nlm.nih.gov/32877…

Berberine ameliorates cellular senescence and extends the lifespan of mice via regulating p16 and cyclin protein expression: https://pubmed.ncbi.nlm.nih.gov/31773…

Effects of Sex, Strain, and Energy Intake on Hallmarks of Aging in Mice: https://www.ncbi.nlm.nih.gov/pmc/arti…

Regulation of longevity by FGF21: Interaction between energy metabolism and stress responses: https://pubmed.ncbi.nlm.nih.gov/28552…

Disease-specific plasma levels of mitokines FGF21, GDF15, and Humanin in type II diabetes and Alzheimer’s disease in comparison with healthy aging: https://pubmed.ncbi.nlm.nih.gov/33131…

Aging is associated with increased FGF21 levels but unaltered FGF21 responsiveness in adipose tissue: https://pubmed.ncbi.nlm.nih.gov/30043…

Circulating levels of fibroblast growth factor-21 increase with age independently of body composition indices among healthy individuals: https://pubmed.ncbi.nlm.nih.gov/26042…

Lower All-Cause, Cardiovascular, and Cancer Mortality in Centenarians’ Offspring: https://pubmed.ncbi.nlm.nih.gov/15571…

Favorable Glucose Tolerance and Lower Prevalence of Metabolic Syndrome in Offspring without Diabetes Mellitus of Nonagenarian Siblings: The Leiden Longevity Study: https://pubmed.ncbi.nlm.nih.gov/20398…

Carotenoids Are Associated With A Younger Epigenetic Age And Reduced All-Cause Mortality Risk

Papers referenced in the video: DNA methylation

GrimAge strongly predicts lifespan and healthspan:


GrimAge outperforms other epigenetic clocks in the prediction of age-related clinical phenotypes and all-cause mortality:


Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies: https://pubmed.ncbi.nlm.nih.gov/30475…

Albumin is included as a biological age predictor:





Age-related change data for albumin:


Associations of cardiovascular biomarkers and plasma albumin with exceptional survival to the highest ages: https://www.nature.com/articles/s4146…

HDL: What’s Optimal For Minimizing Disease Risk And Maximizing Longevity?

Meta-analysis for the association between HDL with all-cause mortality risk has identified HDL levels 55 – 60 mg/dL range as optimal. However, that data includes subjects up to 85y-in the video, I present data for 85y – 115yr olds that additionally suggests HDL in the 55 – 60 mg/dL range as optimal. In addition, I show my own HDL data over the past 15 years (n=34), the correlation for HDL with my diet, and how I plan on consistently increasing my 15-year average HDL of ~44 mg/dL to the 50’s.

Blood Testing: What’s Optimal For Triglycerides?

In terms of all-cause mortality risk, is the reference range for circulating triglycerides (TG, <150 mg/dL) optimal?

A meta-analysis of 38 studies in 360,556 subjects with a median age of 48y and a 12-year follow-up reported lowest all-cause mortality risk for subjects with TG values less than 90 mg/dL (equivalent to ~1 mmol; Liu et al. 2013). As shown below, each successive 90 mg/dL increase was associated with a 12% higher all-cause mortality risk. A person with a value closer to the high end of the reference range, ~150 would have a ~7% increased mortality risk compared someone with a value ~90. In other words, there would be 7 more deaths per 100 total people at a TG value of 150, compared with the death rate for people with values less than 90.

tg mortal

Added importance for the association between TG values less than 90 with all-cause mortality risk come from studies of people who have lived longer than 100 years, centenarians. As shown below, triglyceride values less than 101 mg/dL have been reported in 9 of 11 centenarian studies:

tg mort

What’s my TG value? As shown below, I’ve measured triglycerides 23 times since 2015, with an average value of 52 mg/dL:tg 2020

With the goal of keeping triglyceride levels low, are there dietary factors that influence it? When compared with my dietary data, the strongest correlation (r = 0.73, R2=0.5339) is present for triglycerides with my calorie intake. In other words, a higher daily calorie intake is associated with higher levels of triglycerides:

tg vs cals 2020

Based on this correlation, should my triglycerides start to rise in the future, a first step would be reducing my average daily calorie intake, which since October 2019 has been ~2550 calories/day.


If you’re interested, please have a look at my book!


Liu J, Zeng FF, Liu ZM, Zhang CX, Ling WH, Chen YM. Effects of blood triglycerides on cardiovascular and all-cause mortality: a systematic review and meta-analysis of 61 prospective studies. Lipids Health Dis. 2013 Oct 29;12:159.

PRAL, Mortality Risk, and Lifespan

Within the body, meat, grains, and nuts are generally acid-forming, whereas vegetables and fruits are alkaline-forming. Is the distinction between whether your diet is acid- or alkaline-forming important for optimal health and lifespan? In an earlier post, I discussed the importance of PRAL (potential renal acid load) by correlating it with serum bicarbonate and mortality risk (https://michaellustgarten.wordpress.com/2016/02/07/using-diet-to-optimize-circulating-biomarkers-serum-bicarbonate/).

More recent data (a 15-year study of 81, 697 older adults; average age ~61y; Xu et al. 2016) has examined the association between PRAL with risk of death from all causes. In women, acidic PRAL values ( > 0) were associated with a significantly increased risk of death from all causes, as were alkaline PRAL values (< -5.6). In addition, very acidic (~40) and very alkaline (-30) PRAL values were associated with the highest risk for all-cause mortality:


Similarly, in men, when compared with a PRAL = 0, both alkaline (PRAl < -5.6) and acidic (> 29.8) values were associated with increased all-cause mortality risk.


While this data suggests that eating too much meat, grains, and/or nuts may not be optimal for health, it also suggests that eating too much alkaline-forming food, including veggies and fruits, may also not be optimal! My high veggie-based diet yields a very negative PRAL, ~-120 (~ -0.05 PRAL units/calorie), which would seem to put me at increased all-cause mortality risk. To further investigate, I decided to look at the PRAL values of long-lived societies.

The PRAL formula, as reported by Remer and Manz (1994) is:

PRAL = (0.49 * protein intake in g/day) + (0.037 * phosphorus intake in mg/day) – (0.02 * potassium intake in mg/day) – (0.013 * calcium intake in mg/day) – (0.027 * magnesium intake in mg/day).

Life expectancy for Seventh-Day Adventist women is 85 years, a value that is the highest in the world (Fraser and Shavlik 2001). What’s the average daily PRAL value for that population?

  • Average daily dietary data in both vegetarian and non-vegetarian Seventh-Day Adventist women (average age, ~72y) has been reported (Nieman et al. 1989). For vegetarians, total calories = 1452; protein = 47g; phosphosphorus = 889 mg; potassium = 2628 mg; calcium = 628 mg; magnesium = 283 mg. These values yield an alkaline PRAL = -33.2. Because higher amounts of these nutrients can result from an increased calorie intake, it’s important to divide PRAL by the average daily calorie value, thereby yielding  PRAL/calorie. For vegetarian Adventists, this value = -0.02.
  • In non-vegetarian Adventists, total calories = 1363; protein = 55g; phosphosphorus = 892 mg; potassium = 2342 mg; calcium = 633 mg; magnesium = 228 mg. These values also yield an alkaline PRAL = -25.5, and PRAL/calorie = -0.019.

Life expectancy for those who live on the island of Okinawa is among the longest in the world (Miyagi et al. 2003). What’s the average daily PRAL value for Okinawan older adults?

  • The average daily dietary data for 75-year old Okinawans  has been reported (Willcok et al. 2007): total calories, 1785; protein, 39g; phosphosphorus, 864 mg; potassium, 5200 mg; calcium, 505 mg; magnesium, 396 mg. These values also yield an  yield a very alkaline PRAL value = -87.4, and PRAL/calorie =  -0.049. Interestingly, these values are very close to my very alkaline PRAL values of -121, and PRAL/calorie = ~-0.05!

My goal is not just to get to 75 in great health, but to live past 100 (and far beyond). What’s the data in centenarians? Unfortunately, I could only find 2 studies that included dietary data for that age group.

  • In a study of 30 Chinese centenarians (average age, 103y), daily dietary values of 1220 calories, 39g protein, 603 mg phosphorus, 1433 mg potassium, 482 mg calcium, and 355 mg magnesium were reported (Cai et al. 2016), thereby yielding an average daily PRAL value = -20.3, and PRAL/calorie = -0.017.
  • Similarly, in a larger study of 104 Japanese centenarians (average age, 100y), daily dietary values of 1137 calories, 44g protein, 676 mg phosphorus, 1695 mg potassium, 414 mg calcium, and 154 mg magnesium were reported (Shimizu et al. 2003), thereby yielding an average daily PRAL value = -16.3, and PRAL/calorie = -0.014.

In contrast to the data of Xu et al. (2016), these data suggest that an alkaline diet may indeed be optimal for lifespan.

So what’s your dietary PRAL value?

If you’re interested, please have a look at my book!


Cai D, Zhao S, Li D, Chang F, Tian X, Huang G, Zhu Z, Liu D, Dou X, Li S, Zhao M, Li Q.  Nutrient Intake Is Associated with Longevity Characterization by Metabolites and Element Profiles of Healthy Centenarians. Nutrients. 2016 Sep 19;8(9).

Fraser GE, Shavlik DJ. Ten years of life: Is it a matter of choice? Arch Intern Med. 2001 Jul 9;161(13):1645-52.

Miyagi S, Iwama N, Kawabata T, Hasegawa K. Longevity and diet in Okinawa, Japan: the past, present and future. Asia Pac J Public Health. 2003;15 Suppl:S3-9.

Nieman DC, Underwood BC, Sherman KM, Arabatzis K, Barbosa JC, Johnson M, Shultz TD. Dietary status of Seventh-Day Adventist vegetarian and non-vegetarian elderly women. J Am Diet Assoc. 1989 Dec;89(12):1763-9.

Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356-1361.

Shimizu K, Takeda S, Noji H, Hirose N, Ebihara Y, Arai Y, Hamamatsu M, Nakazawa S, Gondo Y, Konishi K. Dietary patterns and further survival in Japanese centenarians. J Nutr Sci Vitaminol (Tokyo). 2003 Apr;49(2):133-8.

Willcox BJ, Willcox DC, Todoriki H, Fujiyoshi A, Yano K, He Q, Curb JD, Suzuki M. Caloric restriction, the traditional Okinawan diet, and healthy aging: the diet of the world’s longest-lived people and its potential impact on morbidity and life span. Ann N Y Acad Sci. 2007 Oct;1114:434-55.

Xu H, Åkesson A, Orsini N, Håkansson N, Wolk A, Carrero JJ. Modest U-Shaped Association between Dietary Acid Load and Risk of All-Cause and Cardiovascular Mortality in Adults. J Nutr. 2016 Aug;146(8):1580-5.