Better health in our 40s
Topics…
- Challenges, building resilience and preventing problems
- The essentials: exercise, diet and other priorities
- Risks and early warning signs
- Screenings & check-ups
- Target heart rates when exercising
- Health records and directives
- What to do – today – to improve your health
- Health checklist – for the 40s and ageing well
- Your proactive health plan
Challenges, building resilience and preventing problems
Challenges
The 40s is a decade when pressures have a tendency of building up – time pressures trying to fit everything into a busy life; work pressures; looking after other people, whether children or parents. These things often get in the way of looking after yourself and, too often, this means cutting corners by skipping exercise; ignoring early warning signs; eating fast food; or not getting medical checkups.
These “shortcuts” often start in the 30s and, by the time the 40s arrive, they become habits that are hard to shrug off. Unfortunately, this is a time when the body is less forgiving of bad habits and a time when health risks accelerate – cardiovascular risk; insulin resistance; muscle and bone loss; stress and its effect on mental health.
Future challenges
The end result of not developing good health habits in our 40s is weakness in the foundations that are needed to underpin health for the future. This is like using concrete without enough cement – it will work OK for a while, but it won’t have the same underlying strength or long-term resilience.
You don’t want to be one of those people who, in the years to come, have to deal with debilitating diseases including cancer, arthritis, diabetes, heart disease, etc, that can be traced back to your lifestyle in your 30s and 40s.
On the other hand, the right proactive habits will keep you healthy and fit for decades.
Bad habits can not only cause, or contribute to, chronic diseases in the long-term. For example, the effectiveness of your immune system is likely to be compromised which will increase your vulnerability to avoidable illness in the short-term also.
Building resilience and preventing problems
Being proactive, rather than reactive, will prevent some potential health problems and, for those that can’t be prevented, will enable early detection and the undoubted benefits of early treatment.
It will also help you to sustain a high level of health, and therefore a better quality-of-life, for longer than you would if you remain reactive, particularly if you put extra effort into:
- physical fitness including strength training;
- cardiometabolic health (blood pressure, cholesterol, glucose);
- managing stress, including emotional regulation.
These three factors are strong predictors for people in their 40s of future quality-of-life, but they are not the only ones.
There are many other proactive practices that are necessary for good on-going health including diet – important for cardiometabolic health (#2 above) and the management of stress; regular check-ups; good quality sleep; and being mentally active. An expanded list is summarised in the Checklist for the 40s below and explained further in the following paragraphs. More information is available by following the links to the resource sections of this guide.
It’s not just your physical health that is at stake. Your cognitive ability, mental health and looks are all improved by good proactive health habits.
By the way, including “looks” is not being superficial – people who look after their appearance are more particular about the food they eat and the exercise they do, both of which have a beneficial effect on general health. They also tend to look after their skin more, which can make a significant difference to their appearance, and sense of identity, in the years to come.
Some tips about gaining and maintaining good habits are in section 9 Healthy people have better habits.
The essentials: exercise, diet and other priorities
Exercise
Physical activity is essential for good health. It should include stretching to maintain flexibility (dynamic stretching to warm up before exercise and static stretching after exercise). It should also involve resistance or weight-bearing activity to strengthen bones and offset the muscle loss that starts in the 30s.
Aerobic exercise is important – for both your heart and your brain – and the 40s is a good time for intensive exercise, because it gets more difficult to start when you get older.
Activities such as circuit training, running, swimming, cycling, etc – done in a way that is reasonably challenging – will make you feel good from the release of endorphins and, if you push hard enough, you will experience the “runners high”.
Intensive exercise also has longer term benefits – it increases the number of mitochondria (those “little batteries” in your cells that produce energy) which means more energy for your body and brain. It will also give a bigger boost to your metabolism. On the other hand, weight-bearing exercise will make your mitochondria stronger and, in turn, more efficient at producing energy and better at handling stress and inflammation.
To fully appreciate how important physical activity is and what you should do, you may want to review section 3 – Physical activity.
Diet and nutrition
Diet (section 2 Diet/Nutrition) is equally as important so it’s wise to make sure you are eating the right foods. But what are the “right” foods?
Many people think this means avoiding fast or highly processed foods and eating fruit and vegetables. That’s a good start but it doesn’t go far enough – the right diet includes a wide variety of vegetables, legumes, grains and fruits. This is essential for proper nourishment of your gut bacteria (see section 2.5 – Microbiome), which play such a critical, but underappreciated, role in good health.
In addition to variety, your gut bacteria need food that contain probiotics (e.g. fermented foods such as yogurt) and prebiotics (such as oats and legumes).
Without these, your microbiome will lack the necessary diversity and quantity of microbes, which can lead to poor health, including increased anxiety and memory deterioration.
The right diet will also support your metabolism by keeping your blood pressure, cholesterol, blood sugar and weight within a healthy range. Protein-rich foods will preserve muscle mass and vitamins – calcium and vitamin D – are needed to support bone health. There is a lot more information about the right diet, including foods that contain the necessary vitamins and nutrients, in section 2 – Diet and nutrition.
Other priorities for good health
While exercise and the right diet are essential, they are not the only factors that are important and need to be managed. Sleep, stress, avoidance of toxins, dental health, avoiding some substances (tobacco) and minimising others (alcohol) are also important: see section 6 – Other health priorities.
Unfortunately, some of these other factors also become a victim of time pressures. For example, it is not uncommon in our 40s to get less sleep, often done intentionally to free up an extra hour or 2. This is counter-productive because less sleep makes us less productive. Also, as explained in section 6.1 Sleep, not getting 7-9 hours of sleep on a continuing basis can have quite serious adverse consequences for your health.
Stress is another factor that needs to be managed for good health. It can contribute to cardiovascular problems, particularly if you have a family history or sedentary lifestyle, and the 40s can be stressful (see section 6.2 – Stress Management).
It may also be necessary to manage perimenopause, usually accompanied by hormonal shifts that affect mood, sleep and energy.
Risks and early warning signs in our 40s
Many risks don’t give any advance warning. Conditions like hypertension, cardiovascular disease and cancer can often develop silently, without any symptoms – see No early warning signs in section 8.
But many do have early warning signs. For example, our metabolism slows down in our 40s which often means putting on weight. If addressed early by adjusting diet and increasing exercise, the serious problems associated with being overweight – heart disease; diabetes; thyroid dysfunction; etc – can be avoided.
So, it’s important to listen to what your body is telling you and not dismiss an early warning sign as “just ageing” no matter how minor it may seem – sometimes, a minor change can be an indication of a more serious problem on its way. On the other hand, an early warning sign might be “just ageing”.
How do you know the difference?
Have a look at the table below that deals with risks which either emerge or increase in our 40s. There is also a long list of early warning signs and symptoms in section 7 – Early warning signs – including “what’s normal, and what’s not”. However, many signs or symptoms indeterminate and can point to different problems, so it’s always wise to be sure checking with your GP.
| Health Risk | Signs or symptoms | Notes |
|---|---|---|
| Arthritis | Morning stiffness, discomfort after repetitive tasks in hands, hips or knees | Rheumatoid arthritis can start from the 30s onwards |
| Cancer | Indeterminate or no early warning signs | The risk of skin (melanoma), prostate , breast and bowel cancer rises during the 40s. Screening becomes important |
| Depression or anxiety | Irritability; low energy, mood or motivation; poor sleep; changes in appetite; loss of interest in activities and/or social connection | This decade often involves significant life transitions, hormonal changes, and increased pressures from career, finances and family responsibilities that can contribute to poor mental health |
| Diabetes: Type 2 | Being overweight and lack of exercise; often there are no signs or they are mistaken for normal ageing | The risk increases in the 40s; screening is important for blood glucose and kidney function for people at risk (family history, obesity, etc) is important. |
| Heart disease, high blood pressure and stroke | Being overweight and breathlessness after mild physical activity are possible indicators but there are not always any early signs | The risk arises in the 40s so blood pressure and cholesterol should be checked; if any symptoms or family history, checks should be done annually. |
| Obesity and visceral fat | Visceral fat wraps around vital organs such as the liver, pancreas and intestines. It can be present even in people with flat bellies and low body fat percentages. | Metabolism slows down so obesity becomes harder to redress See section 2.4 – Weight management |
Screenings & check-ups for the 40s
It is important in our 40s to have regular screenings – especially for those health problems that don’t have meaningful early warning signs. Early detection can make a big difference. For example, bowel cancer screening should be conducted every 2 years from age 45; colonoscopies are recommended every 5 years
from age 45; mammograms are available from age 40; blood tests should include a PSA reading, a possible indicator of prostate cancer. There are other recommended tests in the table below. Further reading: The Truth About Hidden Health Risks in Your 40s and 50s.
| Test / checkup | Recommendation |
|---|---|
| Bowel cancer | 2 yearly testing now recommended from age 45 |
| Breast cancer | Mammogram – available every 2 years from age 40 |
| Cervical cancer | HPV screening every 5 years from age 25 to 75 |
| Cardiovascular / heart health | Annual cholesterol, blood sugar and blood pressure checks especially if there is a family history or any symptoms |
| Diabetes & kidneys | Testing for blood glucose and kidney function every 3 years or more often if hypertension, obesity or a family history of diabetes |
| General health | GP visit recommended annually for broad review of health |
| Perimenopause | Assessment from mid 40s when symptoms usually emerge |
| Prostate cancer | Discuss with your GP getting PSA included in your next blood test |
| Skin cancer | Annual checkup is recommended |
It is, of course, advisable to get screenings done more regularly if there are any early warning signs or increased risk factors, such as your lifestyle or family history.
Target heart rates for exercising
Your target heart rate will depend on your objective, your age and your level of fitness. The first step is to work out your maximum heart rate (MHR) which is obtained by subtracting your age from 220. Therefore, a person who is 40 has a maximum heart rate of 180 bpm (beats per minute). If his/her goal is aerobic activity, the rule of thumb is to aim for 60-70% of your MHR i.e. a heartbeat between 108 and 126 bpm. There is more information on the table below.
Although it is a common misconception that fat burning only happens in zone 2, it does in fact happen across zones although zone 2 is optimal for sustained aerobic fat metabolism. It is also a misconception that a higher heart rate always means better fitness, whereas training in lower zones also. In fact, training in lower zones can build endurance and support recovery.
| Goal | Zone | BPM age 40 | Activity Examples |
|---|---|---|---|
| Light exercise or recovery | Zone 1 (50–60%) | 90-108 | Gentle walking, yoga, light stretching |
| Aerobic / Fat burning | Zone 2 (60–70%) | 108-126 | Brisk walking, steady swimming, light cycling |
| Cardiovascular endurance | Zone 3 (70–80%) | 126-144 | Jogging, moderate cycling, swim intervals |
| Speed & power | Zone 4–5 (80–100%) | 144-180 | Sprinting, HIIT, hill climbs |
Health records & directives
Health records: If you are injured or suddenly fall ill away from home, and need to be treated urgently, your medical records could be critical to the outcome of your treatment. That’s why it’s important to ensure they are accessible online. Talk to your doctor about this: see section 6.11 – Important Health Documents
Why a Will is not enough: If you are in an accident or become very ill, perhaps incapacitated, or even in a coma, who will pay your bills, arrange banking and otherwise manage your affairs?
You need to appoint someone in writing to manage your finances (a Power of Attorney). You also need a document enabling someone to make healthcare decisions for you (an Enduring Guardianship and Advance Health/Medical Care Directive): see section 6.11 – Important Health Documents.
What to do – today – to improve your health
- Make a commitment to become more proactive and tell someone close to you about your decision, what you are going to do and when.
- Make a list of proactive steps you are going to take and when you are going to start on each one.
Below is a brief checklist for the 40s and a template for a proactive health plan that should be adapted by you for your specific circumstances, level of fitness and state of health.
Checklist – for the 40s and ageing well
- Aerobic exercise for cardiovascular health
- Weight-bearing exercise for muscular health
- Maintain a balanced diet with adequate protein
- Get bone density check if at risk
- Beware of mental health if under stress
- Keep up sun protection; annual skin check
- Keep an eye on weight and waist circumference
- Prioritise sleep despite life pressures
- Manage stress proactively
- Monitor blood pressure and cholesterol
- Strengthen social connections
Your proactive plan
Putting your plan in writing is an important step towards improving your health. The more specific and detailed it is the better. For example, instead of saying in column 2 below “Aim for 3 hours of exercise per week”, it will be more effective if you say “Jog 4km at a brisk pace each Wednesday and Saturday morning”. Instead of saying “Maintain a consistent sleep schedule” say “Go to bed at 10 PM and get up at 6:30 AM each day”.
You may want to do this on an Excel spreadsheet so that you can put in the starting date and add columns for each day of the month to keep track of how well you are progressing with your plan. Ideally, each day you will put a tick or a cross against each step that you have decided to embark on. Remember, consistency is the key – it is better to do a little bit every day, and continue doing it until it becomes a habit (see section 9 – Healthy people have better habits), than to do too much and burn out. That means – don’t set your sights too high when you start.
If you also want to track changes to various aspects of your health after embarking on your plan, have a look at section 10.2 – Track your progress
| Proactivity focus | Details of what I am going to do | How often | Day 1 |
|---|---|---|---|
| Deep breathing – see section 6.3 Breathing | I breathe deeply [in for 4 seconds; hold for 4; out for 4; and hold again for 4] and do it for 1-2 minutes whenever I need a deep breathing boost. The trigger to remind me to do this is … [e.g. when I start to lose concentration OR when I feel tense or under stress OR when I don’t feel happy, etc] | Multiple times throughout the day | |
| Diet & nutrition – see section 2 Diet/Nutrition | I eat a wide variety of vegetables, fruits, legumes and whole grains by adding …. [state specifically what foods you are going to add to your diet] | Daily | |
| I limit sugar intake, processed foods and salt [be specific what you are going to reduce or eliminate from your diet] | Daily | ||
| I boost my microbiome with probiotic and prebiotic foods [state the specific foods e.g. fermented foods – yoghurt, sauerkraut, etc] | Daily | ||
| Exercise – see section 3 Physical Activity | I do 30 minutes of … [e.g. brisk walking] twice per week before breakfast | Tuesday & Friday | |
| I swim for 30 minutes once per week | Saturday | ||
| I do weights [or use resistance bands] to preserve muscle twice per week | Monday & Thursday | ||
| I do balance exercises (e.g. tai chi, yoga) twice per week | Saturday Wednesday | ||
| I play tennis [or golf, etc] once per week | Sunday | ||
| I do a minimum of 10,000 steps every day | Daily | ||
| Medications | I check for interactions or side effects with GP or pharmacist if there are any changes in the way I feel and for any new drug | Insert date | |
| Mental health | I stay mentally active by … (e.g. puzzles, reading) See section 4.2 | Daily | |
| I learn … [e.g. about the 100 years war OR a new language OR a musical instrument] | Daily | ||
| I work on brain health [specify what you are going to do] See cognitive training section 4.2 | Insert when | ||
| I work on being positive See section 5.2 | Insert when | ||
| I take part in a purposeful activity [ e.g. volunteering or a project such as renovating part of your garden] See section 4.2 | Insert date | ||
| Mindfulness – see section 5.3 Mindfulness | I engage in mindfulness regularly during each day. The trigger to remind me to do this is … [when I daydream OR when I find my posture is poor OR when I lose concentration OR when I walk through a doorway OR … etc] | Multiple times per day | |
| Screenings & check-ups | Blood test including PSA and blood sugar; Colonoscopy; Mammogram; Skin cancer check; Eye test; Bone density scan, etc | Insert dates (month and year) for each one | |
| Sleep hygiene – see section 6.1 Sleep | I go to bed at 10pm and get up at 6:30am | Each day | |
| No screens 1 hour before bed | Each day | ||
| Address snoring or sleep apnoea with GP | Insert date | ||
| Social connections | I join a community group or interest-based club [be specific about what and when] | Insert date | |
| I stay engaged with friends and family, or community groups [be specific about what you are going to do and when] See section 4.2 | Weekly or monthly | ||
| Symptoms & early warning signs | I monitor changes to the way I feel and keep a written record of any signs that I think are unusual. See section 7.2 | Ongoing | |
| Vaccinations – see section 6.8 Vaccinations | I get an annual flu and pneumonia shot; I get a Covid 19 booster | Insert date for each one | |
| Other | This is for other issues that may be important for you |