Many of us have heard the story of gritty Uncle Kimo who lived to a ripe old age even though he ate poorly, never exercised, smoked and drank up until the day he died. Unfortunately, Kimo is an exception.

While our genetic heritage is a major determinant of how healthy we are and how long we live, research has shown that lifestyle has a greater impact still. What matters is that lifestyle is the place we can make a difference in how well we feel and for how long.

U.S. News & World Report recently published a comprehensive review on specific actions one can take to optimize longevity. Fully half of the recommendations consider what we eat, how much we weigh and how active we are.

Anyone who has been on a weight-loss diet and counted calories knows how much rigorous exercise it takes to make up for seemingly minor lapses or indiscretions. At the end of the day, as well as in the beginning and the middle, what we eat matters.

Fast food is so tempting. It is convenient, tasty and cheap. The problem is that cheap comes with a high price tag. The salt content places us at risk for high blood pressure, while the fat content raises cholesterol. All of the white bread, white rice and white potatoes, together with soft drinks, places us at risk for diabetes.

Author Paul Hawken, in his book "Blessed Unrest," says we end up paying far more for fast food than we think — both as individuals and as a society. Fast food not only drives up the cost of health care, but also the processes that affect our environment and contribute to global warming. He argues that the carbon footprint associated with production and transportation of nonorganic and nonlocal food should be reflected in what we pay for it. Doing so would make the price of local, organic food farmed in a sustainable fashion more reasonable in comparison.

Longevity is also about attitude and relationship. Centenarians are more emotionally stable, extroverted, conscientious and active in the community than their shorter-living peers, according to a study reported in U.S. News & World Report. Centenarians tend to be better at handling stress and are more easily able to let go in the face of loss or adversity, the study said.

In any case, the truth is that few centenarians are obese and not many drink or smoke. Unfortunately, we can’t all be like Uncle Kimo.

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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.