I, like the above posters, have a couple examples of people who kept their health into old age. However, I've worked in nursing homes and retirement communities for a good part of my life, and that's a whole other side of the coin. I routinely came across people in their 50's and 60's who could barely walk, people bedridden due to obesity or so thin they were wasting away. Not to mention the fact that most of the population begins putting on significant weight after their 40's (or earlier). Look to those who've made it into old age with their health, certainly, but let's not kid ourselves - most elderly in this country are not in good health.

I don't judge, but I definitely observe. I regularly see people in their 70s out running and lifting weights, optimistic and future oriented. I also see people in their 30s and 40s who are debilitated: overweight, pale, pasty, sickly, sedentary.

Nature gives us a buffer of energy and vitality that leads us to imagine in our 20s that we are invincible, such that we feel we can ignore sensible behavioral choices with impunity. In fact, we can — for a while. What we don't realize is: that vitality is there to support us in reproducing and raising kids. After 40-50, that buffer gets thin, such that we need to make life-replenishing choices if we want to combine vitality and age.

These observations are, of course, oriented to the importance of lifestyle choices. Genetics play a significant role, too. Yet there's no doubt in my mind that most people with lousy health profiles, across the age spectrum, can assign very very little blame to genetics. Even lousy genetics and be improved by diet and exercise and mindset — all of which, in fact, can and do foster longevity-and-health genetic expression.

I have an 88 year old grandfather who is the most vivacious person I know. He comes from a clan of French Canadians who are known for their longevity (all of his elder siblings and cousins lives until their late 90s or 100s). My grandmother is 81 and together they just celebrated their 60th wedding anniversary this past year. My grandmother is Sicilian and also from a long lived family, but does make a lot of homemade pasta dishes. But isn't all that they eat. They store bacon grease to griddle their pancakes in, eat lots of ice cream and puffed rice cereal, but it seems to be working for them. It might be like the old German woman and their pastry in Edward's comment. They get good fats, aren't afraid of meat, my grandmother's sauce is filled with pork ribs, sausage and meatballs, and they are both really healthy. Nightshades galore too, but it doesn't seem to be a problem. My grandfather has the more crinkly face but he has the spirit to live for forever. He just loves live and keeps busy, I think that has something to do with it. He retired at 65 for about 3 months and then started his own business which he still runs today. So I think attitude and genetics play a role. He even drives to my sister's house every morning to walk my nephew to kindergarten every day. I like seeing healthy elders, because it is definitely inspiring.

My 93 year old grandmother is extremely healthy. She says she has never had a stomach ache in her life except once when she was pregnant. She had never taken much medicine, though she did do HRT. She has all her teeth and they were always straight. She says she never ate anything special, but she always cooked from scratch and when she grew up during the Depression they drank raw milk.

Contrast that with her children and their children, most of which have crowded crooked teeth and stomach problems that only abate with strict diets. My mother says she doesn't understand why this is the case considering that her mom fed them mostly "real food" with plenty of seafood and organ meats. I don't know...maybe it's because she didn't breast feed them? Maybe it's because they didn't eat much dairy growing up? They had more access to candy?

Interestingly, one of my grandmother's other siblings are alive. Two were killed in war. One died of type 2 diabetes (she said he always loved candy and lost all his teeth in his teens because of it). Another died of ovarian cancer, which also killed my grandmother's mother when she was pretty young.

My other grandmother is also much younger than this grandmother and is on 10 medications and has had several serious surgeries. She lived an inactive suburban life and got into the low fat craze. She eats tons of processed low-fat food. That's unfortunately the state of most American elders I meet.

If there is anything I've learned from my healthy grandmother it's that staying active is REALLY REALLY important, as is bone health. A broken hip can kill, so it's important to have strong bones (through good diet and resistance training) and good balance.

I don't know that I scrutinize the faces of the elderly, but of the older generations I know have had overall better health. I had 4 great-grandparents that lived into their late 90s, grandparents that lived into their late 70s or 80s...My husband's father and paternal grandmother easily look and act 30 years younger than they are - his grandmother is in her 80s, has beautiful unlined skin, lovely hair, no aches and pains, still works at her church - and eats mostly a WAPF type diet. More grains than paleo, but way less than SAD.