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Original Article The impact of nutritional status on centenarians’ physical, mental, and functional health Ivan David Lozada-Martinez a, b, *, Laura Vindas-Meza c, Sandra Castelblanco-Toro b, d, Juan Carlos Salazar-Uribe b, e, Juan-Manuel Anaya a, b, ** a Universidad de la Costa, Barranquilla, Colombia b Centenarians Alliance, Bogota, Colombia c Asociacion Península de Nicoya Zona Azul, Nicoya, Costa Rica d Intellectus Memory and Cognition Center, Hospital Universitario San Ignacio, Institute of Aging, Faculty of Medicine, Pontiﬁcia Universidad Javeriana, Bogota, Colombia e Universidad Nacional de Colombia, Medellín, Colombia a r t i c l e i n f o Article history:

Received 14 January 2025 Accepted 23 January 2025 Available online 27 January 2025 Keywords:

Centenarians Longevity Nutritional status Patient outcome assessment Health status s u m m a r y Background & Aims: Nutrition has been described as a lifestyle factor strongly associated with health phenotypes in extreme longevity. However, little is known about its relationship with health-related outcomes in centenarians.

Methods: A cross-sectional study was conducted from the COOL- CEN cohort. The Mini Nutritional Assessment (MNA) and the Prognostic Nutritional Index (PNI) were used to determine nutritional status, which were correlated with clinical, health status, and biochemical variables.

Results: The sample included 139 centenarians, 74% (n¼103) were female. Centenarians at risk of malnutrition (47%; n¼66) and those with an absolute PNI value < 38.8 (54%) represented the most signiﬁcant proportion. MNA was positively correlated with functional independence (r2 ¼ 0.734, P < 0.05), cognitive assessment (r2 ¼ 0.650, P < 0.05), and functional performance (r2 ¼ 0.619, P < 0.05). Inadequate physical performance, frailty, sarcopenia, severe dementia, some degree of dependency, low PNI, and avoiding the use of dental prosthesis were signiﬁcantly associated with nutritional vulnerability (P < 0.05).

* Corresponding author. Universidad de la Costa, Barranquilla, Colombia.

** Corresponding author. Universidad de la Costa, Barranquilla, Colombia. E-mail addresses: ilozada@cuc.edu.co (I.D. Lozada-Martinez), anayajm@gmail.com (J.-M. Anaya). Contents lists available at ScienceDirect Clinical Nutrition Open Science journal homepage:

www.clinicalnutritionopenscience.com https://doi.org/10.1016/j.nutos.2025.01.010 2667-2685/© 2025TheAuthors. Published by ElsevierLtd onbehalfofEuropean Societyfor Clinical Nutrition and Metabolism. Thisis an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Clinical Nutrition Open Science 60 (2025) 10e20 Descargado para Anonymous User (n/a) en Pontifical Xavierian University de ClinicalKey.es por Elsevier en mayo 19, 2025. Para uso personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2025. Elsevier Inc. Todos los derechos reservados.

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Conclusions: This study identiﬁed that nutritional status in centenarians is associated with functional and cognitive status, physical performance, use of dental prostheses, and speciﬁc biochemical and anthropometric variables. These ﬁndings are relevant for decision-making in general and specialized healthcare and for public health policymakers to build evidence-based strategies to promote healthy aging.

© 2025 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Introduction Extreme longevity has become a topic of increasing interest due to global life expectancy, which has led to a signiﬁcant rise in the proportion of octogenarians, nonagenarians, and centenarians [1,2]. Much has been hypothesized regarding the factors associated with successful aging and extreme longevity [3e5]. However, evidence suggests that aging is a multidimensional, multilevel, and multidirectional process [6], in which proximal and distal inﬂuences contribute to the aging phenotype in diverse ways, depending on the characteristics of the population and the environment in which the life cycle unfolds [7]. Nutrition is perhaps the most debated factor regarding its potential inﬂuence on the aging phenotype [8,9]. Some claim that the Mediterranean diet, characterized by high ﬁsh consumption, reduced red meat intake, and moderate alcohol consumption, is associated with successful aging and extreme longevity [8,9], as previously sought to be demonstrated in centenarians [10], representing the extreme phenotype of longevity. However, the evidence remains too heterogeneous and fragmented to conclusively support such claims [11].

From a clinical perspective, nutrition is a key determinant of health that, in theory, should be associated with other health outcomes essential for strengthening extreme longevity [8,9,12,13]. These outcomes help ensure functional independence, autonomy, and dignity, which are important predictors of healthy lifespan and survival in centenarians [13]. In Colombia, aging is one of the most signiﬁcant demographics changes the country is facing in terms of healthcare, social security and pension system [14]. Therefore, identifying speciﬁc protective or risk factors related to nutritional statusdfactors that can be modiﬁed to maintain adequate nutrition and promote positive health outcomesdis crucial for evidence-based health decision-making and developing healthcare strategies for extreme longevity. This study explored the association between nutritional status and healthrelated outcomes in Colombian centenarians.

This study was reported according to STROBE guidelines [15].

Methods Study design Cross-sectional study derived from the Colombian Centenarian Cohort Study (COOLCEN Cohort) [14].

Setting and participants Participant data came from the COOLCEN cohort study. The COOLCEN study is a nationwide longitudinal study involving centenarians in Colombia, starting in September 2023. This study applied simple random sampling to select subjects aged 100 years and older, whose ages were veriﬁed by identiﬁcation documents or state records, and who provided written informed consent. No exclusion I.D. Lozada-Martinez, L. Vindas-Meza, S. Castelblanco-Toro et al.

Clinical Nutrition Open Science 60 (2025) 10e20

Descargado para Anonymous User (n/a) en Pontifical Xavierian University de ClinicalKey.es por Elsevier en mayo 19, 2025. Para uso personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2025. Elsevier Inc. Todos los derechos reservados.

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criteria were determined. The centenarians were assessed at their home or at a geriatric outpatient and were included in ﬁve provinces of Colombia (Atlantico, Bogota D.C., Bolívar, Sucre, and Valle del Cauca). Variables The outcomes, whether categorical or quantitative, were the results of the Mini Nutritional Assessment (MNA) score [16] and Prognosis Nutritional Index (PNI) [17,18] used to determine the nutritional status of centenarians. Independent variables were sociodemographic, economic, functional, cognitive, and clinical characteristics.

Data measurement A semi-structured questionnaire collected data during a medical interview with the centenarian and their caregiver. We used the MNA score and PNI to measure the nutritional status. To be eligible for the application of this questionnaire, participants did not need to be fully cognitively intact but able to reliably respond to questions about themselves. In some cases, caregivers or relatives helped them comprehend and respond to the questions. If the participants were unable to sign the informed consent, their legal representatives did so.

We used the full MNA scale [16] and recorded quantitative and qualitative results of this scale. The MNA consists of 18 items with a range of 0e30 points and determines three nutritional status categories: 1) Normal nutritional status (24e30 points); 2) At-risk of malnutrition (17e23.5 points); and 3) Malnourished (less than 17 points).

The PNI is an indicator of nutritional status and inﬂammation [17,18], used as a predictor of morbidity or mortality in older persons, especially in acute care scenarios. However, it is hypothesized that it may serve as a valuable predictor of health-related outcomes in organically stable long-lived individuals, as it is directly related to nutritional status. The PNI is calculated using serum albumin and blood lymphocyte count [10 Albumin (g/dL)] þ [0.005 blood lymphocyte (cells/mm3)]. We used an absolute cut-off score of 38.8 based on previous studies [17,18]. Therefore, a value 38.8 was considered high, while a value < 38.8 was considered low.

We measured frailty by using the Fried scale and sarcopenia using the SARC-F scale [19]. To determine functional status, we used the Barthel Index [20], Lawton and Brody [20], Downton [21] and Short Physical Performance Battery (SPPB) scales [22]. The Mini-Mental Status Exam (MMSE) [23], the Montreal Cognitive Assessment (MoCA) [24], and the Clinical Dementia Rating (CDR) [25] evaluated the cognitive status. Yesavage scale [26] computed depression, and GAI-SF (Geriatric Anxiety Inventory e Short Form) [27] assessed anxiety. The Insomnia Severity Index (ISI) scale [28] measured the sleep quality. We evaluated the quality of life and well-being using the World Health Organization Quality of Life (WHOQOL) and The Satisfaction With Life Scales (SWLS) scales [29], respectively. Prosociality was examined, focusing on perceptions of caregiving, feelings of loneliness, social interactions, contact, and experiences with any form of violence. We also explored biochemical parameters of interest in the health status of extreme longevity related to lipid metabolism, renal proﬁle, thyroid proﬁle, and inﬂammatory markers, among others [30].

Statistical methods KolmogoroveSmirnov test showed the normality of quantitative variables. Data are presented as median (interquartile, IQR) for skewed variables. Qualitative variables were summarized using frequency and percentages.

We conducted comparative analysis using Pearson's Chi-square test or Fisher's exact test for qualitative variables and Mann-Whitney U test or Student's t-test for quantitative variables. Multiple regression analyses and Pearson's or Spearman's correlation coefﬁcient tests evaluated associations and correlations between MNA, PNI, and the other outcomes. Due to multiple statistical comparisons and to avoid the risk of type I error, P-values were adjusted by the Bonferroni correction. A P-value < 0.05 was considered statistically signiﬁcant. All analyses were performed using the R statistical package (Version 4.3.1) (https://www.r-project.org/).

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Ethical statement This study complied with Act 008430/1993 of the Ministry of Health of the Republic of Colombia, which classiﬁed it as minimal-risk research. The institutional review board approved the study design. Results A total of 139 centenarians were included, with a median age of 101 years. Of these, 74% (n¼103) were female, and 80% lived in urban areas. Eighty percent (n¼111/138) belonged to a low or very low socioeconomic level, 87% (n¼119/137) had one or less minimum wage as household economic income, and only 4% (n¼5/133) had completed at least secondary school (Table 1). According to the Barthel index, 44% (n¼61/138) had total independence or mild dependence, while the prevalence of frailty and sarcopenia was 75% (n¼99/132) and 73%, respectively, and cognitive impairment was present in 73% (n¼86/118). Seventy-nine percent (n¼108/137) of centenarians had no upper teeth, while 64% (n¼88/138) had no lower teeth. Only half of the population used dental prostheses (Table 1).

When evaluating nutritional characteristics, the centenarians predominantly had not decreased food intake in the last three months (58%), 56% had a body mass index (BMI) less than 19 kg/m2, and the Table 1 Demographic and clinical characteristics of the population studied (N¼139) Variable N

Age (years), median, (IQR)

101 (3)

Sex Female

103

Residence area Urban 109/137

Educational Level Without education 89/133

Primary education 39/133

Upper secondary education or higher 5/133

Household Economic Income

<1 MMW

96/137

1 MMW

23/137

1e2 MMW 13/137

> 2 MMW

5/137

Socioeconomic level Very low 68/138

Low 43/138

Lower-middle and higher 27/138

Functionality Independence 18/138

Mild dependence 43/138

Moderate dependence 15/138

Severe dependency 19/138

Total dependency 43/138

No Upper teeth 108/137

No Lower teeth 88/138

Use of dental prosthesis

Frailty 99/132

Sarcopenia

101

Favorable physical performance 19/137

Depression 20/130

Anxiety 1/131

Cognitive impairmenta 86/118

Insomnia 26/137

Favorable life satisfaction 108/130

a MMSE 24. MMW: Minimum monthly wage ($303,10 for the year 2024).

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majority consumed three meals a day (87%). Protein intake was adequate in 49%, 61% fed themselves without difﬁculty, and 63% considered themselves free of nutritional problems. The most representative proportion was that of centenarians at risk of malnutrition (47%; n¼66) and those with an absolute PNI value less than 38.8 (54%) (Table 2).

Correlations were found between the MNA and PNI and health-related outcomes. The MNA demonstrated a strong positive correlation with functional independence (Barthel Index; r2 ¼ 0.734, P < 0.05), cognitive assessment (MoCA; r2 ¼ 0.650, P < 0.05), and functional performance (SPPB; r2 ¼ 0.619, P < 0.05). Additionally, it showed a strong negative correlation with clinical dementia rating (CDR; r2 ¼ -0.671, P < 0.05). Similarly, the PNI was positively correlated with cognitive assessment (MoCA; r2 ¼ 0.417, P < 0.05), functional independence (Barthel Index; r2 ¼ 0.364, P < 0.05), and functional performance (SPPB; r2 ¼ 0.364, P < 0.05) (Table 3). When discriminating by gender, we identiﬁed that both the positive and negative correlations between the MNA and functional independence (Barthel Index; r2 ¼ 0.712 vs. 0.675), cognitive assessment (MoCA; r2 ¼ 0.643 vs. 0.421), clinical dementia rating (CDR; r2 ¼ -0.651 vs. -0.599), and other health-related outcomes were stronger for women compared to men (Table 4). By establishing two nutritional status phenotypesdnutritional vulnerability (malnourished þ at risk of malnutrition) and good nutritional statusd nutritional vulnerability was linked to inadequate physical performance (P < 0.001), frailty (P ¼ 0.002), sarcopenia (P <0.001), severe dementia (P < Table 2 Nutritional characteristics of the population studied (N¼139) Variable n

Food intake over the past 3 months Severe decrease in food intake

Moderate decrease in food intake

No decrease in food intake

Weight loss during the last 3 months Weight loss greater than 3 kg

Does not know

Weight loss between 1 and 3 kg

No weight loss

Body Mass Index BMI less than 19

BMI 19 to less than 21

BMI 21 to less than 23

BMI 23 or greater

Full meals consumed by the patient eat daily

1 meal

2 meals

3 meals

121

At least one serving of dairy products per day

Two or more servings of legumes or eggs per week

125

Meat, ﬁsh or poultry every day

129

MAC

MAC less than 21

MAC 21 to 22

MAC greater than 22

CC CC less than 31

106

CC 31 or greater

Nutritional status Malnourished

At-risk of malnutrition

Normal nutritional status

Nutritional supplement intake

PNI

High 46/99

Low 53/99

CC: Calf circumference; MAC: Mid-arm circumference.

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0.001), some degree of dependency (P < 0.001), low PNI (P ¼ 0.004), and not using dental prostheses (P ¼ 0.0016). Additionally, severe dementia was found to be signiﬁcantly associated with a low PNI value (P ¼ 0.0112) (Table 5).

The complete and detailed description of the evaluated domains can be found in the tables of the supplementary material (Tables S1-S5). Discussion Nutrition is a key element in the regulation of health and disease in humans [31,32]. Studies in nutrigenomics identiﬁed nutrition's role in the complex regulation of metabolic processes and the microbiome, with direct implications for disease prevention [31,33,34]. These ﬁndings show that Table 3 Correlations between nutritional status and main clinical, functional, and biochemical variables in centenarians (N¼139) Variable

MNA

PNI

QoL (WHOQOL-AGE) 0.491a

0.217

Functional performance (SPPB) 0.619a 0.364a Cognitive assessment (MoCA) 0.650a 0.417a Mini mental status (MMSE) 0.552a

0.321

Clinical Dementia Rating (CDR) -0.671a

-0.311

Depression (GDS-15) -0.411a

-0.058

Frailty (Fried scale) -0.434a

-0.210

Functional independence (Barthel Index) 0.734a 0.364a

BMI

0.498a

0.106

Calf circumference 0.537a

0.093

Mid-arm circumference 0.494a

0.025

Deltoid circumference 0.539a

-0.028

Grip strength 0.488a

0.294

Hematocrit

0.078

0.347a Albumin

0.285

0.998a Albumin fraction

0.302

0.521a

BUN

0.174

0.399a Testosterone 0.349a

0.344

BMI: Body Mass Index; BUN: Blood Urea Nitrogen. a <0.05 after Bonferroni's correction. Table 4 Correlations between nutritional status and main clinical, functional, and biochemical variables by gender in centenarians (N¼139) Variable

MNA

PNI

Men Women Men Women Cognitive assessment (MoCA)

0.421

0.643a

0.356

0.275

Mini mental status (MMSE)

0.410

0.470a

0.395

0.216

Clinical Dementia Rating (CDR) -0.599a -0.651a

-0.417

-0.225

Depression (GDS-15)

-0.401

-0.434a

-0.030

-0.048

Functional independence (Barthel Index) 0.675a 0.712a

0.414

0.301

BMI

0.479

0.474a

0.167

0.099

Heel-to-knee height

0.360

0.423a

0.333

0.236

Mid-arm circumference 0.554a

0.442

0.277

0.052

Deltoid circumference 0.562a 0.503a

0.070

0.042

Grip strength 0.487a 0.580a

-0.073

-0.000

Hematocrit

0.075

0.084

0.131

0.439a Albumin

0.351

0.257

0.996a 0.998a Testosterone

-0.296

0.354

-0.076

0.268a BMI: Body Mass Index.

a P<0.05, after Bonferroni's correction. I.D. Lozada-Martinez, L. Vindas-Meza, S. Castelblanco-Toro et al. Clinical Nutrition Open Science 60 (2025) 10e20

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nutrients, phytochemicals, and microRNAs are absorbed through diet and digestion, contributing to the development of the microbiome, which, in turn, inﬂuences epigenomic regulation and gene expression [33]. These processes regulate appetite, inﬂammation, immunity, and metabolism [33]. This intricate relationship between diet and biological factors is essential for shaping the aging phenotype, which is directly related to extreme longevity [34]. From a clinical perspective, it is crucial to understand the dietary characteristics and variables most strongly associated with the nutritional status of centenarians to establish valid and effective evidence-based interventions.

In this study, it was found that 47% of the population was at nutritional risk, followed by 36% experiencing malnutrition, despite 58% reporting no reduction in food intake, 62% reporting no weight loss or being unaware of it, 87% consuming three full meals a day, and 91% having an adequate or regular protein intake. However, it must be noted that 67% of the centenarians had no formal education, 87% lived in households with up to one minimum monthly wage, 80% belonged to a low or very low socioeconomic status, and 76% reported serious difﬁculties in meeting basic needs. This suggest that, despite no reduction in food intake, the quality of the diet may be poor due to a lack of food security and freedom [35]. Therefore, it would be important to identify the speciﬁc dietary characteristics to assess centenarians' nutritional intake.

Similarly, the missing teeth (64% vs. 79% for lower and upper teeth, respectively) and the fact that only 50% of those without teeth use dental prostheses likely have a signiﬁcant impact on chewing Table 5 Associations between nutritional status, speciﬁc characteristics, and health-related outcomes Variable

MNA (N¼139)

PNI (N¼99)

Nutritional vulnerabilitya Good nutrition P-value Low High P-value Functional performance (SPPB) Inadequate performance

106

<0.001b

0.3898

Adequate performance

Frailty Fit

0.002b

0.0801

Pre-frail

Frail

Sarcopenia No

<0.001b

0.2615

Yes

Mini mental status (MMSE)

<0.001b Normal (26e30)

0.0074

Cognitive impaired (24)

CDR

No dementia

<0.001b

0.0112

Questionable dementia

Mild dementia

Moderate dementia

Severe dementia

PNI

Low (<38.5)

0.004b – – – High (38.5)

– – – Functional independence (Barthel Index) Independence

<0.001b

0.1008

Some degree of dependence

107

Downton Low

0.019

0.3056

High

Use of dental prosthesis No

0.0016b

0.4247

Yes

CDR: Clinical Dementia Rating; MNA: Mini Nutritional Assessment; PNI: Prognostic Nutritional Index; SPPB: Short Physical Performance Battery.

a Nutritional vulnerability [malnourished þ at risk of malnutrition].

b P<0.05, after Bonferroni's correction.

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quality and, consequently, on overall eating behavior. More than 50% of centenarians have a body mass index of less than 19 kg/m2; however, the centenarians (or their families) perceive themselves as having no nutritional issues. This perception may be inﬂuenced by the widespread belief in the irreversible decline or deterioration of long-lived individuals and the lack of awareness about the potential for recovery of intrinsic capacity and functional capacity [36]. This could result in an overestimation of the centenarian's health status, while, in fact, they are in a nutritional vulnerability state that requires intervention by healthcare providers.

Nutritional variables we studied directly inﬂuence functional independence, physical performance, cognitive status, and quality of life. Nutritional status was negatively correlated with depression and frailty. These ﬁndings indicate that nutritional status is directly associated with the overall health phenotype of the centenarian and all related domains. Longitudinal studies have previously demonstrated this long-term association in centenarians. However, the speciﬁc nutritional variables that most signiﬁcantly contribute to survival outcomes remain insufﬁciently understood [37]. In most domains, the correlations were stronger among female centenarians compared to males. However, there were some slight variations in the correlations between genders. Females predominated in this cohort so that this trend may reﬂect differences between the two groups. Some anthropometric measures, such as grip strength and deltoid circumference, showed consistent patterns regardless of gender distribution. This serves as a reference to infer that muscle mass is directly correlated with nutritional status [38] and with the overall health status of centenarians. This trend is more pronounced with the MNA compared to the PNI. Although the PNI has been associated with inﬂammatory status, potentially linked to the nutritional state, it was found that hematocrit, albumin, and blood urea nitrogen had the strongest and most signiﬁcant correlations. This contrasts with previous research, which suggested that ferritin and C-reactive protein could be blood markers of inﬂammation in centenarians [39]. Inﬂammaging could not be a predominant subphenotype in this Colombian cohort of centenarians.

In this context, centenarians with nutritional vulnerability are expected to experience negative impacts on their health phenotype, including reduced brain health, loss of functional independence and autonomy, diminished physical performance, and neuropsychiatric instability. Therefore, strengthening nutritional status should be considered a key target in the healthcare of centenarians. This should be accompanied by the implementation of interventions aimed at rehabilitating the nutritional status of centenarians to promote a healthy lifespan and functionality in this population. Dietary diversity [40] and the long-term association of nutritional status [41], as well as their medical intervention, represent signiﬁcant gaps of interest for future research on the nutrition of this population. Opportunities and limitations This is a novel study from a geographic area characterized by racial and cultural mixing [42]. The identiﬁcation and recruitment of centenarians present signiﬁcant challenges including ageism and healthcare access [43,44]. According to the National Administrative Department of Statistics (DANE https://tinyurl.com/msn9wre3), in 2023, it was estimated that there were 19,400 centenarians in Colombia. As part of an ongoing study on Colombian centenarians, 139 individuals were included in this analysis. We acknowledge that no sample size was previously deﬁned. However, the study ensured that both the sample size was adequate, and the statistical methods were correctly applied allowing to produce reliable results, ultimately leading to accurate conclusions that can inform and suggest practice, policy, and further research.

The study indicates the effects of nutritional status of centenarians on health-related outcomes and clinical variables, providing valuable information for subsequent analyses. The shortcomings of this manuscript are acknowledged. It should be mentioned the bias from the non-speciﬁcity of existing diagnoses in the medical records derived from the centenarians' regular health care by their health insurance company, which could confound the actual prevalences of chronic diseases. The crosssectional design and the lack of a full dietary assessment may be considered as a limitation. However, the MNA is an important tool in research on extreme longevity because of its ability to fully measure nutritional status, predictive validity for health outcomes, and usefulness in leading interventions to improve the quality of life for older persons.

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Conclusion This study identiﬁed that the nutritional status and phenotype in centenarians are associated with functional and cognitive status, physical performance, use of dental prostheses, and speciﬁc biochemical and anthropometric variables. Some of these associations tend to be stronger depending on the centenarian's gender. These ﬁndings are relevant for decision-making in general and specialized healthcare and for prescribing clinical interventions in centenarian populations. Author contributions IDLM and JMA contributed to the conception and design of the study. IDLM, SCT, JCS and JMA carried out data collection and data cleaning. IDLM, JCS and JMA performed the statistical analyses and were involved in data organization and presentation. IDLM, LVM, JCS, and JMA drafted the manuscript. IDLM, LVM, SCT, JCS and JMA critically reviewed the manuscript with suggestions for improvement and revision. All authors read and approved the ﬁnal version.

Availability of data and materials The dataset generated and analyzed is available and provided on request. Ethics approval and consent to participate This study was performed in compliance with Act 008430/1993 of the Ministry of Health of the Republic of Colombia, which classiﬁed it as minimal-risk research. The institutional review board of Universidad de la Costa approved the study design.

Consent for publication Not applicable.

Funding Universidad de la Costa, Barranquilla, Colombia (Project code INV.2021-04-001-19). Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or ﬁnancial relationships that could be construed as a potential conﬂict of interest. Acknowledgments We extend our special thanks to the members of the Colombian Centenarians Alliance who made the design and maintenance of this national prospective study possible. To the University EIA, Soluciones Moleculares SAS, Clínica de la Costa, the Ofﬁce for the Older Persons of the Bogota Health Secretary, and particularly to the commitment of the centenarians and their offspring for their desire to contribute to the study, understanding, and promotion of extreme longevity in our country. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi.org/10.1016/j.nutos.2025.01.

010.

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Cita: Lozada-Martinez, Ivan David, Vindas-Meza, Laura, Castelblanco-Toro , Sandra, Salazar-Uribe, Juan Carlos, Anaya, Juan-Manuel (2025), The impact of nutritional status on centenarians’ physical, mental, and functional health, Pontificia Universidad Javeriana, p. N. http://hdl.handle.net/10554/69980