I really love the idea that Akyuu is actually really fit from her routine of taking care of her weak body. Like, the past Children of Miare died young just because they had weak bodies. Nothing more supernatural than that.
It is different this time for the ninth generation, however, as the Maiden of Miare now has access to modern – or better yet, divine healthcare. Like, even before the Eternal Night Incident, she was probably already taking supplements Yukari procured. And as of the present, she probably has appointments with Eirin, and with Reisen checking up on her on a weekly basis.