Abstract Body (Do not enter title and authors here): Background
Supercentenarians (age 110 and above) and semi-supercentenarians (105~109) display extraordinary cardiovascular resilience. Yet, the dietary exposures underpinning this longevity remain underexplored due to inconsistent methodologies across regions. The Global Supercentenarian Cohort Network Study (GSCNS) aims to provide a globally harmonized framework to investigate nutrition as a modifiable factor in achieving CVD free extreme longevity.

Hypothesis
We hypothesize that consistent dietary traits, characterized by plant-forward, nutrient-dense, low inflammatory food patterns, contribute to reduced lifetime cardiovascular risk among supercentenarians.

Methods
A scoping review of 139 peer-reviewed studies (1990~2025) informed a two-round Delphi consensus with 35 global experts. This process resulted in the GSCNS protocol, comprising 256 standardized items. Key dietary assessments include the Mini Nutritional Assessment-Short Form (MNA-SF), Food Frequency Questionnaire (FFQ), and longitudinal dietary recall. Protocol items emphasize total caloric intake, macronutrient composition, food group frequency, and cultural dietary practices.

Results
Synthesized findings from literature across longevity hotspots reveal convergence in dietary traits.
High intake of vegetables, legumes, and whole grains
Moderate fish and fermented food consumption
Minimal red meat, sugar, and ultra processed foods
Regular green tea consumption and traditional preparation methods
Sustained caloric moderation across the life course
These patterns correspond with lower prevalence of myocardial infarction, hypertension, and stroke, and were prioritized by consensus for inclusion in future longitudinal cohort investigations.

Conclusions
The GSCNS protocol provides the first globally validated, diet-focused framework to study cardiovascular health in extreme old age. This foundational work supports the hypothesis that lifelong adherence to plant-centric, anti inflammatory diets contributes to cardiovascular resilience, offering a path forward for global nutrition policy and preventive cardiology.