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Mito was alive when Kushina was a wee lad
Tsunade did state that. She can't die ever
Tsunade did state that. She can't die ever
You look like you're shitting on the floor
Tsunade is alive because of a beneficial combination of nature and nurture. Due to her Senju Hashirama (not Senju, but Senju HASHIRAMA) and Uzumaki clan genetics, her life force, longevity, and chakra are first class. It is not surprising that she can live long based on that alone.
However, it is Tsunade's nurture that is the big reason for why she is alive. Yes, she has the byakugou, and yes it reduces your lifespan by overuse. But it only reduces your lifespan IF it is used. That is Tsunade's trick. She is the best medic in the world, so for normal wounds she can just heal herself with medical ninjutsu, something Sakura had been doing up until she herself received the byakugou (against Sasori for example.) Next, as a medic, Tsunade knows that she is needed primarily out of direct combat, keeping her out of harm for the most part. In fact, because in her time there were so many battles, it would be rare for her to be anywhere by herself that she would have to fight and necessitate to byakugou. But, if Tsunade does need to defend herself, she is the strongest woman in the world. Literally. Byakugou usage would not be necessary to handle most situations. In fact, we have only seen her use it around four times in the manga. And as a doctor she would know what to eat, drink, etc., to keep herself healthy.
In conclusion, Tsunade's inherent nature and nurture are the reason why she is still alive an more or less healthier than most.
What do you think?
The nurture (her training as both a medic and a fighter) does play a part.
Tsunade is a medical ninja first and foremost. Anbu are educated on the human body to assist in their murders, but Tsunade's main education was in the medical arts. She knows the body better than anyone shown in the manga. That includes the body and the things put into the body (supplements, nutrition, etc.) All of this knowledge surely influences how she lives her life in order to keep herself (at least medically) in peak performance.
You cannot stop yourself from getting old, but you can ensure that your body lasts longer. This is the modus operandi of those in the medical fields.
What do you think?