Many people believe growing old automatically means becoming frail and battling chronic illnesses. However, a new report on healthy ageing argues that while ageing is inevitable, much of what determines how well people live in later years is influenced by everyday choices rather than genetics alone.
The Living Longer, Better report, unveiled earlier this year at the Smart Ageing Summit in Oxford, United Kingdom, presents a compelling case that individuals have far greater influence over their health and longevity than commonly assumed. It challenges long-held beliefs that physical decline is an unavoidable consequence of getting older, instead pointing to lifestyle, environment and mindset as the strongest drivers of healthy ageing.
According to the report, ageing itself is a natural biological process, and while genetics play a role, they are only one part of the equation.
"The rate of ageing is influenced by genetic and lifestyle factors but is not normally a cause of major problems until the later 90s."
The report further argues that people bear significant responsibility for their health outcomes in old age.
"Individuals bear at least 80 per cent of the responsibility for their ill health in old age."
Researchers identified three major causes of ill health: infection, genetic inheritance and lifestyle, including personal habits and mindset. They stress that the way people eat, move, sleep and interact with their environment throughout life has a lasting impact on how they age.
One of the report's key findings is that many people mistake the effects of declining fitness for ageing itself. According to the authors, physical fitness often begins to deteriorate in early adulthood, particularly after people adopt sedentary lifestyles or begin spending long hours sitting at work.
"Loss of fitness, results from inactivity, often beginning with the first car or the first sedentary job which often occur together, usually in the early twenties."
The report explains that reduced physical activity leads to weaker muscles and lower resilience, making it harder for the body to cope with physical challenges. Because these changes closely resemble the effects of ageing, many assume they are simply growing old when, in reality, much of the decline is linked to inactivity.
Researchers also distinguish ageing from disease, noting that illnesses associated with older adults are not always caused by age itself.
"Disease is an abnormal process, sometimes related to ageing but more often due to social and environmental factors. It is often complicated by accelerated loss of fitness."
Another major conclusion is that genetics may not be as powerful in determining lifespan as once believed. Instead, scientists increasingly point to what is known as the "exposome"—the lifelong interaction between individuals and their physical and social environments.
"The most important factor from childhood onwards is our exposome – our interaction with the social and physical environment."
The report recommends adopting healthy habits early in life, noting that small but consistent improvements can significantly increase both lifespan and quality of life. A balanced diet, regular exercise and quality sleep remain the cornerstones of healthy ageing, but researchers say mental wellbeing and social engagement are equally important.
Studies cited in the report found that dietary patterns such as the Mediterranean diet and plant-based eating plans are consistently associated with longer life expectancy, even among people with a genetic predisposition to shorter lifespans. These diets typically emphasise fruits, vegetables, legumes, whole grains and fibre-rich foods while limiting sugary drinks and ultra-processed foods.
High fibre intake was identified as having one of the strongest statistical links to increased longevity, while diets high in ultra-processed foods were associated with accelerated biological ageing.
Exercise also delivers benefits that extend beyond weight management. According to the report, regular physical activity strengthens the heart and muscles, activates the body's natural cellular repair mechanisms and may even help deprive cancer cells of glucose. Researchers noted that adding as little as two minutes of moderate-to-vigorous physical activity each day, alongside modest dietary improvements, can contribute to a longer and healthier life.
The report also highlights the growing importance of biological age—the measure of how much wear and damage the body has accumulated over time—as opposed to chronological age. Unlike chronological age, biological age can improve through healthier lifestyle choices, regardless of a person's actual years.
Beyond nutrition and exercise, experts identified several additional factors linked to healthy ageing, including avoiding smoking and vaping, maintaining meaningful social relationships, pursuing hobbies and cultivating a positive attitude towards ageing.
Researchers also warned about the dangers of chronic inflammation, describing it as an emerging driver of age-related diseases such as dementia. Conditions including obesity, gum disease and untreated gut infections during midlife can increase inflammation, making healthy sleep, stress management and maintaining a balanced gut microbiome increasingly important.
Despite advances in longevity science, the report concludes there is no single formula for living a long and healthy life.
"Ultimately, there is no single magic bullet for a long and healthy life. It's a combination of good habits and perhaps a bit of luck."
Encouragingly, researchers say perfection is not required to enjoy the benefits of healthy living.
"One study found that even the top fifth of healthy eaters didn't have perfect dietary scores, which is positive because it shows you don't have to be an absolute goody two-shoes all the time to benefit."
The report concludes that the earlier people begin making healthier choices, the greater the long-term rewards, reinforcing the message that while ageing cannot be stopped, healthy ageing is, to a large extent, within reach.