Everyone is different, no single rule applies to all, and there is always that one person who lived to a great age while drinking, smoking, eating badly and doing little exercise. The latter, however, is the exception, not the norm.
For most of us navigating the bodily changes that come with middle-age, the good news is that it’s never too late to change bad habits. But it is important to change them now because the consequences of not doing so could ruin your later life.
Dr Alice Wilkenfeld is an internal medicine physician and founder of Vesta Internal Medicine. She sat down with RG Best Health to explain what most middle-aged men and women experience, and how to prevent the most common health complaints from becoming debilitating, or worse.
Natural ageing
At some point between the age of 40 and 50, our bodies start to change. This can include muscle loss, slowing metabolism, reduced lung capacity, decreased kidney function, elevated blood sugar, increased blood pressure, hormonal changes, and issues with cholesterol.
“Every organ system in our body changes,” Dr Wilkenfeld said. “That’s natural ageing.”
Hormone changes
These affect men and women differently. Dr Wilkenfeld said women “go through this wild vacillation between 40 and 50, which is the perimenopause. One day, you feel fine, and the next day, you’re mad at everything.”
For men, it’s more subtle.
“Their testosterone will go down, but it doesn’t fluctuate like women’s hormones, it’s steady, she explained.
“When you think of men’s biology, producing sperm, it’s a constant thing, but women, we have to ovulate and that’s more cyclical and there’s more ups and downs of all the hormones, which is why there are a lot of changes like hot flushes.”
Cardiovascular risks
Cardiovascular disease is the number one killer of people over the age of 50 but, Dr Wilkenfeld warned, it tends to appear 10 years earlier in men.
One warning sign for men can be erectile difficulties.
“That’s a big canary in the coal mine that you could have cardiovascular disease, because the whole mechanism works via blood flow,” she said.
“It’s not just, ‘go take a little blue pill’. There may be something systemic going on.”
Going to your doctor regularly could help to prevent cardiovascular conditions.
“There are blood tests to look at different markers related to cholesterol. There are special scans that can be done called the coronary calcium score. It’s like a quick CT scan and there are algorithms that we use to put all those things together, and then look at your family history.
“There are things you can change, things you can’t. What you can’t change is your genetics. What you can change is your lifestyle.”
Lifestyle
According to the World Health Organisation, the leading causes of cardiovascular disease are unhealthy diet, lack of exercise, tobacco use and too much alcohol. In addition to this are “environmental risk factors” and genetic risks.
We can’t control our genetics or what’s in the air, but we can control how we look after our bodies and for this, Dr Wilkenfeld turned to the “six pillars of lifestyle medicine”.
These are nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances and social connection.
- Nutrition
“Don’t eat fake food. Eat food that looks like what it is,” she advised. “You take it home, you chop it up, you cook it, or you eat it in a salad.”
If you do have to buy packaged food, read the ingredients first.
“If there’s something you can’t pronounce, you probably shouldn’t eat it.”
She recommended meat or fish in its natural form, along with an ideal goal of 30 different fruits and vegetables in a week.
“That means you put, for example, carrots and kidney beans and some different greens and some herbs, and then the next night, you have cauliflower with onion. If you use a lot of different things when you’re cooking, it can come up to that.”
That also includes foods like non-packaged oatmeal and whole grains. Essentially, half of your plate should come from plants.
Sugar should also be limited to a maximum of six teaspoons per day for women and nine for men.
- Physical activity
Exercise in your midlife years should be a regular combination of aerobic exercise and strength training. Per week, Dr Wilkenfeld recommended 150 minutes of moderate aerobic exercise such as walking, or 100 minutes of more intense exercise. A 15-minute walk after a meal is particularly beneficial because it helps blood sugar and metabolism.
She also recommended 40 minutes of strength training twice a week to maintain bone strength and muscle mass – but it has to be an effort.
“It should be that you can’t lift the weights more than six or seven times. Not just five-pound weights 100 times.”
- Restorative sleep
Seven to nine hours of sleep a night is ideal, which can be hard, but there are sleep facilities in Bermuda that can help.
“If you don’t sleep, your body can’t repair itself so that affects your health as well and then that leads to stress.”
- Stress management
The hardest pillar, in Dr Wilkenfeld’s opinion, is stress management because “you can’t make it go away”.
Asking for help, however, could enable you to deal with it. This could be from family, community or a therapist who can teach you how to navigate the issues successfully.
- Avoidance of risky substances
Smoking tobacco is a well-known carcinogen with links to a myriad of other fatal diseases, but smoking “anything” is also bad, especially vaping because “we don’t know what it’s going to do down the road.”
There is mixed advice out there about alcohol, but the WHO has declared that there is no safe amount of alcohol consumption as it has also been linked to a variety of cancers and can harm the heart and brain.
“Do I say you can’t have wine? No, just moderate,” but, “if you don’t drink now, don’t start.”
- Social connections
A sense of community is important, especially activities such as team sports, going to church or meeting up with friends.
“Whatever helps you have social connectivity,” she said. “That’s what keeps people going.”
How to change bad habits
Prevention is the key to everything.
Dr Wilkenfeld advised: “If you’re between early 40s to 60s, you have a chance to prevent permanent damage to your lungs or heart.”
You can do this by seeing your GP regularly and attending any recommended health screenings such as mammograms and prostate checks.
Then, it’s about embracing the six pillars of lifestyle medicine, although she admitted few of us can change everything all at once.
The most important ones are excessive drinking and smoking. Then, she said: “See what would be easiest to start with, pick one, and do a little bit.”
With exercise, for example, “start with 10 minutes, five days a week, then slowly increase it until it becomes more of a habit.”
“The thing of it is,” she laughed, “it’s everything that your grandmother told you. Get enough sleep, eat real food, eat fruits and vegetables, move your body around. Don’t overdo things. Don’t eat too much sugar, drink too much or smoke.”
