Dietary supplements and longevity: what do Chinese centenarians take?

Living to be 100 is no longer an absolute rarity. In 1995, there were approximately 125,000 centenarians worldwide. By 2015, there were already more than 450,000, and projections suggest that this number could exceed 25 million by 2100. This demographic explosion is generating growing interest: what are these people doing differently to reach such an advanced age while often maintaining a certain degree of independence and a (relatively) good quality of life?

Researchers agree on one point: longevity does not depend on a single factor, but on a complex combination of genetics, environment, and lifestyle. Diet, physical activity, sleep, and stress management are among the most studied factors. While the global market for supplements now exceeds $150 billion, and public health campaigns in some countries emphasize their potential role in preventing aging, very few studies have looked at their actual use among the world’s oldest people. The available research mainly concerns younger populations or seniors aged 60 to 80. So, in a world where dietary supplements are becoming increasingly popular, rightly or wrongly, do centenarians use nutritional supplements, and if so, which ones?

The study

To attempt to answer this question, a study led by Jozo Grgic and based on a large Chinese national cohort explored the types, frequency, and duration of dietary supplement use among 2,877 centenarians. The analysis is based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a large-scale survey conducted since 1998 in 23 Chinese provinces. This project, unique in its scope and duration, aims to understand the social, environmental, and biological factors associated with longevity. For this study, the researchers used the eighth wave of data, collected in 2018, where a specific module on the use of dietary supplements was added for the first time.

Among the 15,874 participants aged 65 and over, 2,877 centenarians were included (2,169 women and 708 men). The average age was 102.1 years. The majority lived in rural areas and had worked in agriculture or crafts before the age of 60. Approximately 90% of them did not smoke, did not drink alcohol, and more than 80% did not engage in structured exercise.

The supplement questionnaire included several simple but specific questions. Participants were first asked to indicate whether they regularly consumed a nutritional supplement (“yes” or “no”). Those who answered “yes” then had to specify the type of supplement, the duration of use, and the frequency of consumption. The categories offered covered the most common supplements: protein, calcium, iron, zinc, multivitamins, vitamins A/D, omega-3 fatty acids (DHA), and an “other” category for any supplements not listed. The duration of use was expressed in years, and the frequency according to three levels: “sometimes,” “rarely,” or “often.” Data analysis was performed separately for men and women.

The study did not seek to establish a causal relationship between supplementation and longevity, but rather to describe the behaviors of this exceptional population. In other words, the aim was to understand what centenarians themselves did, not to explain why they had lived so long.

Results & Analysis

The main results show that only 11% of centenarians reported using dietary supplements, a remarkably low figure compared to younger populations. Among women, the prevalence was 10.7%, and among men, 12.3%, a non-significant difference. These rates contrast sharply with those observed in other countries: in the United States, about 70% of people over 60 take supplements, and in Europe, the proportion varies between 30 and 50%. In China, even among younger seniors (aged 65–85), the figures do not reach 20%.

The supplements most commonly used by centenarians were calcium (6.5–7.3%), followed by protein (3.7–5.8%) and multivitamins (2.8–3.0%). Other products were much less common: vitamins A/D (~2%), iron and zinc (~1.2–1.4%), and DHA (less than 1%). The median duration of use varied from 2 to 10 years depending on the type of supplement. Calcium and protein were the most regularly taken supplements, often for 5 years or more. The majority of users reported taking their supplements “often” rather than ‘sometimes’ or “rarely.” This indicates regular use, even among individuals over 100 years of age. Finally, the vast majority (nearly 90%) of users took only one supplement, rarely two, and almost never three or more. In other words, poly-supplementation, which is very common in Western countries, was virtually non-existent in this population.

Among Chinese centenarians, supplementation appears to be incidental. It is not a widespread habit, nor is it an obvious prerequisite for longevity. This is consistent with observations from other longevity cohorts, such as those in Okinawa, Sardinia, and Nicoya, where longevity is based primarily on a traditional balanced diet, rich in plants, moderate in calories, and low in ultra-processed foods.

The authors point out that the low use of supplements can be explained by several factors. First, affordability: centenarians who grew up in rural China in the mid-20th century experienced periods of war, shortages, and food restrictions, which shaped frugal habits and a distrust of manufactured products. Second, the level of education and information about nutrition remained limited, as the majority of centenarians in this cohort had never received public health advice on supplementation.

But from a biological perspective, these individuals may have developed exceptional metabolic resilience, allowing them to maintain optimal physiological function throughout their lives without additional supplementation. Several genetic studies have shown that centenarians generally have favorable expression of genes linked to DNA repair, oxidative stress management, and insulin sensitivity. Their bodies would therefore be, by nature, less dependent on external micronutrient intake.

The study also highlights the fact that many centenarians only began taking supplements after the age of 90, sometimes following medical advice or a diagnosis (osteoporosis, protein deficiency). This suggests that most of them did not need supplements to reach 100, but may have adopted them later for comfort or as a late preventive measure.

Finally, unlike what is observed in other countries, no significant difference was found between men and women. In Europe and the United States, older women are traditionally more likely to take supplements (calcium, multivitamins, iron), often for bone health or to prevent deficiencies. Among Chinese centenarians, this distinction disappears, probably because at such an advanced age, behaviors tend to become more uniform.

Practical applications

In practice, this study invites us to put into perspective the role of supplements in “preventing” aging (if it is even possible to avoid aging). The supplement industry thrives on the idea that supplements improve longevity and cognitive function or slow down tissue degradation. However, the oldest and most resilient populations rarely use them, and sometimes not at all. Their health is based on fundamental pillars: exceptional genetics, combined with a high-quality diet, moderate but regular physical activity, strong social ties, low stress, and stable sleep.

However, this does not mean that supplementation is irrelevant. In our modern society, where diets are often unbalanced and specific needs (protein, vitamin D, calcium, omega-3) are more difficult to meet, certain supplements still have real clinical value. They correct specific deficiencies, but can never replace a healthy lifestyle.

Living a long AND healthy life depends mainly on your genetics, followed by your lifestyle. At a time when many charlatans are capitalizing on the theme of longevity, miracle molecules with no side effects have still not been discovered, and it is highly unlikely that the human body is designed to live forever. The key message here is that centenarians offer an effective model of moderation, taking few medications and supplements, but maintaining consistent lifestyle habits. Their approach to nutrition is based more on continuity than on correction. It is decades of balance, rather than a daily capsule, that forge long-term health.

Reference

Grgic, J., Hodzic Kuerec, A., & Schoenfeld, B. J. (2025). Dietary supplement use in longevity: Evidence from 2,877 centenarians. GeroScience.