Centenarians have a distinct gut microbiome composition compared to younger adults. The microbiome regulates inflammation, immune function, and metabolic health — three of the most important determinants of biological age.
A 2016 study of Italian centenarians (100–104 years old) and semi-supercentenarians (105–109 years old) found that extreme longevity is associated with a distinct gut microbiome composition characterised by higher levels of Christensenellaceae, Akkermansia, and Bifidobacterium — bacteria associated with reduced inflammation and improved metabolic function. A 2021 Nature Metabolism study of 9,000 individuals found that people with a more unique, individualised microbiome composition (less dominated by common species) had better health outcomes and lower mortality, and that this uniqueness increased with age in healthy individuals but decreased in those with poor health.
Inflammaging — the chronic, low-grade inflammation that drives most age-related diseases — is substantially regulated by the gut microbiome. A dysbiotic microbiome (one with reduced diversity and overgrowth of pro-inflammatory species) increases intestinal permeability ('leaky gut'), allowing bacterial lipopolysaccharides (LPS) to enter the bloodstream and activate systemic inflammatory pathways. Elevated circulating LPS is associated with accelerated biological aging, increased dementia risk, and higher all-cause mortality.
Vitaei verdict
The gut microbiome is a modifiable determinant of biological age. The evidence-based strategy is straightforward: eat 30+ different plant foods per week, include fermented foods daily, exercise regularly, and minimise unnecessary antibiotic use. These interventions increase microbiome diversity — the most reliable proxy for gut health.
Mediterranean diet and longevity: the most evidence-grounded dietary pattern in medicine
No dietary pattern has more RCT evidence for longevity than the Mediterranean diet. The PREDIMED trial — 7,447 participants, 5 years — showed a 30% reduction in major cardiovascular events. Here is what the evidence actually supports.
Time-restricted eating and longevity: what the evidence actually shows
Intermittent fasting has been oversold and under-nuanced. We examine the best human trials and separate what is established from what is speculative.
Skin microbiome and ageing: the gut-skin axis explained
Your gut microbiome influences your skin through systemic immunity, inflammatory signalling, and metabolite production. The axis is bidirectional, the evidence is growing, and the implications for skin ageing are only beginning to be understood.