Better health in our 50s

50s Snapshot

The 50s is the time to consolidate good health habits, and get rid of the bad habits, or at least some of them.

The reason it’s important to do this in our 50s is partly to build resilience in order to deal with the increased health risks that we face in our 60s and beyond, and partly because our bodies are still highly responsive to changes in our 50s – even small adjustments can significantly reduce the risk of health problems in the future.

The first step is to determine whether you need to make any adjustments and, if so, what adjustments. This is done by reviewing various aspects of your current health that are predictors of future health.  There are some simple tests you can do at home or with your doctor described in Appendix A that will give you the answers.

The next step is to review the recommendations about what proactive steps to take based on your results.

50s Topics…

• Challenges, building resilience and preventing problems
• Predictors of future health
• Essentials – diet, exercise and other priorities
• Risks and early warning signs
• Screenings & check-ups
• Target heart rate when exercising
• Health records and directives
• What to do – today – to improve your health
• Health checklist – for the 50s and ageing well
• Your proactive health plan
• Appendix A.  How to predict your future health
• Appendix B. 50s Physical health risks
• Appendix C. 50s Disease and illness risks

Challenges, building resilience and preventing problems

Challenges

Various health risks increase during our 50s but, despite some of the risks being serious, there’s no need to be alarmed if you follow some simple recommendations, as explained below.

The more serious risks include cancer and cardiovascular disease, especially for those who have a family history of heart related problems or whose lifestyle (e.g. lack of exercise or poor diet) adds to the risk. There will be an ongoing reduction in muscle mass if weight-bearing exercise is not done regularly. Bone density declines, and type 2 diabetes becomes more common, especially if obesity or insulin resistance is relevant. Depression, anxiety and burnout can be a problem due to career issues, caregiving stress or hormonal changes that can affect sleep, mood and metabolism. For women, these hormonal changes are often associated with menopause which typically completes during the 50s.

Future challenges

The risk of not developing and continuing good health habits into our 50s is weakness in the foundations that are needed to underpin health for the future. This is like using concrete without enough cement – it will be OK for some time, but it won’t have the same underlying strength or long-term resilience. And it can cause short-term problems also, including compromising your immune system and thereby increasing the risk of health problems.

The good news

The odds are in your favour. For example, less than 10% of Australians in their 50s have heart, stroke or vascular disease, type 2 diabetes or suffer a stroke. Cancer is estimated at less than 5% although mental health is higher (estimated at up to 15%).

Don’t rely on luck – build resilience and prevent problems

The odds being in your favour doesn’t help if you are one of the unlucky ones so, if you don’t already live by the proactive health principles explained in this guide, it’s time to start. Even if you live by most of these principles, but not all, you should seriously think about extending what you do.

Predictors of future health

Knowing what your future health has in store for you will enable you to make adjustments at a time when you can still make a difference to your health trajectory. This will increase the chances of enjoying the health and quality-of-life you would like in the years ahead.

Three significant predictors for people in their 50s of future health and well-being are:

1. Physical activity – both aerobic fitness and strength – affects more than future mobility. Low fitness in your 50s indicates poorer health, quality-of-life and well-being in the decades ahead including a weaker immune system, higher inflammation, slower recovery from illness and a higher likelihood of reduced independence later in life.
2. Cardiometabolic health – high levels of blood pressure, cholesterol, blood sugar or visceral fat predict a higher risk of heart attack, stroke, diabetes and kidney disease. Elevated levels in our 50s is a strong indicator that proactive steps should be taken.
3. Diet, nutrition and weight management – poor diet in our 50s predicts higher risk of type 2 diabetes, fatty liver and heart disease as our bodies become more sensitive to excess calories, low fibre, high sugar saturated fats and highly processed foods.

These are strong predictors, but they are not the only ones. Social engagement is also a predictor of future well-being. Having a purpose or meaning in life is important for both brain health and general well-being (Cognitive engagement). Screenings take on more significance, especially for cancer – bowel, prostate, breast and skin (Checkups). Consistent sleep is also important (Sleep).

What do your predictors mean? Are they in the danger zone?

Appendix A explains the tests that can be used to check your current health, what the results mean for your future health and suggestions about proactive steps you can take to make improvements.

References: the factors that predict quality-of-life are based on a synthesis of several major studies, including the Harvard Study of Adult Development (https://www.adultdevelopmentstudy.org/) and the WHO Healthy Ageing Frameworks (https://www.who.int/initiatives/decade-of-healthy-ageing)

The essentials – exercise, diet and other priorities

Exercise

Physical activity will minimise the effects of ageing and becomes even more important in our 50s, especially for people who haven’t been engaged in regular exercise before. It should include both aerobic (for cardiovascular benefits) and weight-bearing (to counter muscle loss and strengthen bones – particularly important for addressing osteoporosis).

Weight-bearing doesn’t mean “pumping iron” – resistance bands (large rubber loops) are good for home use and walking uphill, dancing, playing tennis, etc, also qualify. And if you walk briskly, as if you’re running late for a bus, you will derive an aerobic benefit and your heart will thank you.

If you’re up for more intense exercise, such as circuit training, running, etc you will get more benefit, including the short-term boost you will get from the release of endorphins. Intensive exercise also increases the number of mitochondria (those “little batteries” in your cells that produce energy) and more mitochondria means more energy. 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.

It is also important, perhaps even more important as we age, to stretch – dynamic stretching to warm up before exercise and static stretching after exercise or later in the day when your muscles have warmed up (see section 3.6 and section 3.7). To fully appreciate how important physical activity is and what you should do, please have a look at the whole of section 3 – Physical activity.

Diet and Nutrition

Diet is equally important so it may be a good idea to double check to make sure you are eating the right foods. But what are the “right” foods?

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, and weight management, in section 2 – Diet and nutrition.

Cognitive engagement – having a purpose and ongoing learning

To keep our brains sharp, it is important to keep learning – acquiring new skills and/ or engaging in complex tasks help to maintain neural connections. Other important factors include social engagement and purposeful activities such as hobbies, mentoring and creative pursuits that have been shown to enhance mental clarity, and boost motivation. What’s good for your brain.

In addition to having a variety of health benefits, positive thinking helps improve mental health by lowering stress levels and protecting against anxiety. Mindfulness can also contribute to good mental health – it helps to reduce forgetfulness, improve concentration and increase situational awareness: Mindfulness.

The other side of the coin is managing cognitive risks, including loneliness: What’s bad for your brain.

Other priorities that are important for good health

Diet/nutrition, exercise and cognitive stimulation are not the only factors that are necessary for good health in our 50s and beyond. Other factors that need to be managed include sleep; dental health; stress and social connection. Stress management and maintaining strong social ties are also reasonably strong predictors of future quality-of-life. More information is in section 6 – Other priorities for good health.

Social connection

The evidence is remarkably consistent: people who maintain meaningful relationships, regular social contact, and a sense of belonging experience better cognitive health, better emotional balance and lower rates of chronic disease. Social connection reduces stress hormones, supports immune function, and keeps the brain stimulated in ways that solitary activities simply can’t replicate.

The 50s is a time when loneliness can creep in unnoticed if social networks haven’t been maintained, and loneliness (in the sense of feeling alone) is particularly damaging for our mental health. And it can be deadly.

Cardiometabolic health

Cardiometabolic health refers to how well your cardiovascular system (heart and blood vessels) and metabolic system (how your body processes and uses energy) are functioning together. It’s shaped by factors such as blood pressure, cholesterol, blood sugar, body composition (muscle and fat), inflammation, and lifestyle behaviours like diet, exercise, sleep, and stress.

When all these factors are addressed, and you get regular checkups, as part of your proactive health lifestyle, the risk of problems such as heart disease, stroke and type 2 diabetes is lowered significantly.

Risks and early warning signs

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, breathlessness after mild exercise and/or weight gain (both are a possible indication of heart disease although they can also be indicative of other problems).

Have a look at the table below that deals with risks which either emerge or increase in our 50s. 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 are indeterminate and can point to different problems, so it is always wise to be sure by checking with your GP.

Health Risk	Signs or symptoms	Notes
Arthritis	Pain, swelling and reduced range of motion can affect daily tasks	Rheumatoid arthritis can occur as young as 30 and osteoarthritis is possible in your 50s, particularly after an injury.
Cancer	Indeterminate or no early warning signs	Screening for bowel, breast skin and prostate cancer are important in the 50s
Depression or anxiety	Irritability; low energy, mood and motivation; poor sleep; changes in appetite; loss of interest in activities and/or social connection	The risk increases often as a result of career issues, caregiving responsibilities, hormonal changes, etc. Maintain or take up purposeful activities; social connections remain important
Diabetes: Type 2	Often there are no signs or they are mistaken for normal ageing; the risk is higher if overweight or you don’t exercise regularly	The prevalence of this increases in the 50s. Screening – blood glucose and kidney function – is especially important for those with risk factors like hypertension, obesity or family history..
Falls and fractures	Deterioration in balance and mobility	Fractures become more common and osteoporosis exacerbates the danger. Work on mindfulness and balance
Hearing decline	Difficulty picking up words especially in a noisy environment	Hearing problems can contribute to future cognitive decline so it’s important to get hearing tested
Heart disease, high blood pressure and stroke	Being overweight and breathlessness after mild physical activity are possible indicators but there are not always any pre-warning signs	Risk rises due to declining estrogen/testosterone, higher blood pressure and cholesterol changes, which need to be checked. Discuss the possible need for a calcium score with your GP
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.	Peaks in the 50s and 60s and harder to reverse due to metabolic slowdown. See section 2.4 – Weight management
Vision problems	Cataracts – deterioration in vision clarity; glaucoma – no early warning signs	Increased risk needs to be managed by regular checkups

Screenings & checkups for the 50s

It becomes increasingly important in our 50s to have regular screenings – especially for those health problems that don’t have meaningful early warning signs – and to check with your doctor unless you are certain that a physical, emotional or mental change is normal. Early detection can make a big difference.

Test / checkup	Recommendation
Bowel cancer	Every 2 years from age 50 up to 75. Some doctors recommend continuing if life expectancy is more than 10 years
Breast cancer	Mammogram every 2 years from age 40 unless GP recommends otherwise
Cervical cancer	HPV screening every 5 years from age 25 to 75
Cardiovascular / heart health	Annual cholesterol, blood sugar and blood pressure checks;
Colonoscopy	Every 5 years from age 45 to 75
Diabetes & kidneys	Testing for blood glucose and kidney function every 3 years or more often if hypertension or diabetes history
Eyesight	At least every 2 years (glaucoma has no early warning sign)
General health	GP visit recommended annually for broad review of health
Hearing	Testing advisable if any deterioration (loss can contribute to dementia)
Lipoprotein	Discuss with your GP if not already tested
Osteoporosis	Screening may be advisable particularly for post-menopausal women
Prostate cancer	Discuss with your GP including a PSA reading in your next blood test
Skin cancer	Annual testing
Stroke	Annual checks for blood pressure, cholesterol and heart rhythm are recommended for those at risk (family history or lifestyle issues such as smoking, being overweight, having a sedentary lifestyle, etc)
Vaccinations	Shingles and pneumococcal. Regular flu and Covid 19

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) for exercising which can be calculated by subtracting your age from 220. Therefore, if you are 50, your MHR is 170 bpm (beats per minute) although this can vary depending upon level of fitness and state of health, etc. If your goal is aerobic activity, the rule of thumb is to aim for 60-70% of MHR i.e. a heartbeat between 100 and 120 bpm

Although it is a common misconception that fat burning only happens in the 60-70% zone, this is the optimal zone for sustained aerobic fat metabolism. It is also a misconception that “higher heart rate always means better fitness” – this isn’t true because exercising in lower zones builds endurance and supports recovery.

Goal	Zone	BPM age 50	Activity Examples
Light exercise or recovery	Zone 1 (50–60%)	85-100	Gentle walking, yoga, light stretching
Aerobic / Fat burning	Zone 2 (60–70%)	100-120	Brisk walking, steady swimming, light cycling
Cardiovascular endurance	Zone 3 (70–80%)	120-136	Jogging, moderate cycling, swim intervals
Speed & power	Zone 4–5 (80–100%)	136-170	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

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

1. Make a commitment to become more proactive and tell someone close to you about your decision, what you are going to do and when.
2. Check your predictors to see what you should focus on.
3. 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 50s 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. The more you cross-reference the links in this section about the 50s to the relevant part of the Proactive Health Guide, the more you will learn and the better your personal plan will be.

Proactive health checklist – for the 50s and ageing well

• Weight bearing exercise to counter muscle loss
• Cardiovascular exercise (walking, cycling, swimming)
• Monitor blood pressure, cholesterol, and glucose regularly
• Get a bone density scan (DEXA) if relevant
• Review diet to ensure adequate protein, fibre and micronutrients
• Protect joints with low‑impact movement and good technique
• Sun protection and regular skin checks
• Be aware of possible midlife mental health issues
• Check sleep hygiene, including the possibility of sleep apnoea
• Stay socially connected to protect cognitive and emotional wellbeing
• For women: consider menopause management and bone health
• For men: monitor prostate health and metabolic markers

Your proactive plan

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

APPENDIX A: PREDICTORS

How to determine what your future health may have in store for you and what you can do to shape it

This appendix gives you simple ways to find out what various aspects of your current health might be telling you about your future health without the need for special equipment or expensive testing – most checks can be done at home or with your GP. There are also suggestions about what proactive steps you can take based on your results that are

These predictors and suggestions are based on generalised data from medical research and population studies and therefore should be used as guidelines rather than personalised advice.

AEROBIC CAPACITY

Aerobic capacity generally declines more rapidly in our 50s and is a strong predictor of long-term health including the risk of cardiovascular disease, future mobility, quality-of-life and even long-term brain health. You can do either the walking test (test 1) or test or the stair-climbing test (test 2), or both.

Test 1: Walk for 6 minutes

Walk briskly as far as possible in six minutes on a flat surface.

Outcome and what it predicts

• Green zone – being able to walk 550 metres or more without being overly puffed indicates good aerobic capacity for the 50s, lower long-term cardiovascular risk and slower biological ageing.
• Amber zone – 450-550 metres suggests below optimal aerobic fitness and higher risk of cardiovascular disease and reduced mobility in later decades.
• Red zone – less than 450 metres predicts a higher risk of heart disease and increased risk of frailty later decades.

Proactive steps

• Green zone – maintain at least 150 minutes of moderate activity per week including one long exercise session and one faster session per week
• Amber zone – aim for a brisk 30 minute walk five days per week and one 20 minute interval training session (1 minute fast; 1 minute easy)
• Red zone – aerobic activity needs to be increased starting with at least 10-15 minutes of brisk walking 4-5 days per week and gradually increase this until you reach 30 minutes. Your goal is to end up doing the activity recommended for the green zone.

Test 2: Stair climb – three flights

Time how long it takes to climb 3 flights (45 steps) at a steady pace.

Outcome and what it predicts

• Green zone – 50 seconds or less indicates good aerobic capacity and lower risk of future cardiovascular issues.
• Amber zone – 50-65 seconds suggests reduced aerobic capacity, higher future cardiovascular risk and reduced future mobility.
• Red zone – taking more than 65 seconds indicates significantly higher risk of heart disease and reduced functional capacity in later life.

Proactive steps

• Green zone – maintain regular aerobic activity, preferably at least 150 minutes per week of moderate activity (walking, cycling, swimming). Include one longer session (40-60 minutes) and one brisker session each week.
• Amber zone – aim for a brisk 30 minute walk five days per week and one 20 minute interval training session (1 minute fast; 1 minute easy). Ideally, include one stairclimbing session per week of 5-8 continuous minutes.
• Red zone – aerobic activity needs to be increased starting with at least 10-15 minutes of brisk walking 4-5 days per week and gradually increase this until you reach 30 minutes. Your goal is to end up doing the activity recommended for the green zone.

STRENGTH

It is recommended to do both the lower body (test 1) and the upper body (test 2), or both.

Test 1: Lower body: 30 seconds sit-to-stand

With arms crossed, stand up and sit down as many times as possible in 30 seconds from a standard chair seat (43-45 cm high).

Outcome and what it predicts

• Green zone – 12 or more times indicates good lower‑body strength; good predictor of mobility in later decades.
• Amber zone – 8-11 times indicates higher risk of mobility limitations in the 60s and 70s..
• Red zone – 7 or less times indicates a more significant decline in strength which predicts a higher risk of mobility decline, falls and reduced independence.

Proactive steps

• Green zone – do, or keep doing, at least 2 lower body strength sessions (e.g. squats, lunges, step-ups, sit-to-stand) per week each comprising 2-3 sets with 8-12 repetitions per exercise. It should feel moderately hard by the last few repetitions.
• Amber zone – lower body strength sessions (e.g. squats, lunges, step-ups, sit-to-stand) should be added to your exercise program starting with 2 sets of 8 repetitions per exercise once or twice per week and gradually increase the difficulty and the number of repetitions so you end up doing at least two sessions per week with each session comprising 3 sets of 12 repetitions.
• Red zone – follow the suggestions for the Amber zone but start with exercises that are not as difficult (e.g. partial squats and lunges, lower step-ups and sit-to-stand start using a higher chair); increase the frequency and difficulty gradually until you get to the level suggested for the green zone.

Test 2: Upper body: 1 minute of inclined push-ups

Place your hands on the edge of a kitchen bench or sturdy table, no wider than shoulder‑width. Walk your feet back until your body forms a 45° angle to the floor. Keep your body in a straight line from shoulders to heels. Then bend your elbows – keeping them angled back not flared out – and lower your chest stopping when your upper and lower arm form roughly a 90° angle. This should mean your chest is 10-15 cm from the edge. Then straighten your arms fully. This constitutes one full push-up.

Outcome and what it predicts

• Green zone – 15 or more incline push-ups for men, and 10 or more for women, in one minute indicates good upper‑body strength for the 50s, a lower risk of shoulder or neck issues and good long-term functional capacity (lifting, carrying, etc).
• Amber zone – 8-11 times indicates higher risk of mobility limitations in the 60s and 70s..
• Red zone – 7 or less times indicates a more significant decline in strength which predicts a higher risk of mobility decline, falls and reduced independence.

Proactive steps

• Green zone – do, or keep doing, at least 2 upper body strength sessions (e.g. push-ups, rowing and core exercises) per week each comprising 2-3 sets with 8-12 repetitions per exercise. It should feel moderately hard by the last few repetitions.
• Amber zone – upper body strength sessions (e.g. incline push-ups, rowing and core exercises) should be added to your exercise program starting with 2 sets of 8 repetitions per exercise once or twice per week and gradually increase the difficulty and the number of repetitions so you end up doing at least two sessions per week with each session comprising 3 sets of 12 repetitions.
• Red zone – follow the suggestions for the Amber zone but start with exercises that are not as difficult (e.g. wall-push-ups, rowing exercises using resistance bands); increase the frequency and difficulty gradually until you get to the level suggested for the green zone.

CARDIOMETABOLIC HEALTH

Blood pressure; cholesterol; triglycerides; and blood sugar tests need to be arranged with your doctor and can usually be bulk billed. The proactive steps listed after Test 4 apply also to tests 1, 2 and 3.

Test 1: Blood pressure

Outcome and what it predicts

• Green zone – 120/80 or less indicates a lower long-term risk of heart attack, stroke and kidney disease.
• Amber zone – 120-139 systolic or 80-89 diastolic (e.g. 135/85) indicates a higher chance of developing hypertension in the 60s and higher long-term cardiovascular risk if the trend continues.
• Red zone – 140/90 or higher predicts a higher long-term risk of heart attack, stroke and kidney disease and a higher likelihood of needing medical treatment. In our 50s, this is a strong indicator that proactive steps should be taken.

Test 2: Cholesterol

Bad cholesterol (LDL) and what it predicts

• Green zone – less than 2.6 predicts a lower chance of cholesterol building up on the artery walls and lower long-term risk of heart attack or stroke.
• Amber zone – 2.6-3.3 indicates an increased likelihood of plaque build‑up and a higher chance of developing cardiovascular disease starting in the 60s.
• Red zone – above 3.3 indicates a stronger likelihood of plaque formation and higher long‑term risk of heart attack and stroke. In our 50s, this level is a strong signal that proactive steps are needed.

Good cholesterol (HDL) and what it predicts

• Green zone – more than 1.0 for men 1.2 for women indicates better natural protection against cholesterol build‑up and lower cardiovascular risk..
• Amber zone – 0.9-1.0 indicates reduced protective effect and a higher chance of cholesterol accumulating in arteries.
• Red zone – less than 0.9 indicates little natural protection and higher long‑term risk of cardiovascular disease. Low HDL is an important warning sign and should not be ignored..

Test 3: Triglycerides

What they predict

• Green zone – less than 1.7 indicates a healthy metabolism and lower risk of artery inflammation. In our 50s indicates better long-term cardiovascular health.
• Amber zone – 1.7-2.2 indicates a higher chance of cholesterol accumulating in arteries and therefore increased cardiovascular risk in the coming decade.
• Red zone – 2.3 and above indicates higher risk of heart disease, stroke and diabetes.

Test 4: Blood sugar

The following relates to HbA1c – a measurement of blood sugar averaged over the last 2-3 months. It is a better predictor of long-term health than fasting glucose level which is a snapshot of the sugar level at the time of the test.

What it predicts

• Green zone – less than 5.7% indicates lower risk of developing insulin resistance or type 2 diabetes.
• Amber zone – 5.7-6.4% indicates higher chance of developing type 2 diabetes in your 60s.
• Red zone – 6.5% and above indicates a higher risk of cardiovascular disease including diabetes. This level in the 50s indicates that proactive steps should be taken.

Proactive steps for blood pressure, cholesterol, triglycerides and blood sugar

• Green zone – maintain a healthy lifestyle including regular physical activity (at least 150 minutes per week walking, cycling, swimming, or similar); 2 strength sessions per week for upper and lower body; a balanced diet with a variety of fruits and vegetables; and a consistent sleep routine.
• Amber zone – the goal is to have a healthy lifestyle as described for the green zone including the adoption of a Mediterranean style diet; increasing fibre; reducing salt and processed foods. Also, if overweight, the goal should be a 5-10% weight reduction.
• Red zone – in addition to the recommendations for the amber zone, it is wise to consider medical advice relating to diet and possible medication.

These predictors and suggestions are based on generalised data from medical research and population studies and therefore should be used as guidelines rather than personalised advice.

STRESS and EMOTIONAL REGULATION

Test 1: Sleep

Sleep is a strong predictor of long-term physical, emotional and cognitive health. The simple test involves calculating how many nights per week you: fall asleep within 30 minutes; stay asleep without long waking periods; and wake up feeling reasonably restored?

Outcome and what it predicts

• Green zone – 5-7 nights per week indicates a well‑regulated stress system and emotional stability, lower risk of depression/anxiety, better cognitive ageing and lower risk of long-term cardiovascular disease.
• Amber zone – 3-4 nights per week indicates a higher chance of developing chronic stress and sleep problems, increased risk of weight gain and reduced emotional resilience, including irritability, in the next decade.
• Red zone – 2 or less nights per week indicates higher long-term risk of depression/anxiety, higher risk of a weaker metabolism (including diabetes), increased cardiovascular risk and faster cognitive ageing. It is a strong warning sign that should not be ignored.

Proactive steps

• Green zone – maintain a consistent sleep schedule and avoid bad habits that sometimes creep up such as phone or TV screens close to bedtime, late coffee, etc.
• Amber zone – advisable to adjust sleep habits, including consistent bed and wake times, limit caffeine after midday, reduce screen time 30-60 minutes before bed – [link to sleep]; increase physical activity (1-2 extra sessions of light to moderate activity per week) and reduce alcohol intake (even small reductions help) (e.g. 20 minutes walking per day).
• Red zone – sleep hygiene needs to be given priority – [link]; add the following to your daily routine: relaxation practices; more physical activity; and stress management. Consider professional sleep therapy advice if poor sleep persists, especially if it affects mood, energy or daily function.

Test 2: Resting heart rate

Your BPM (beats per minute) can be tested by counting your pulse to determine how many mornings per week your resting heart rate in the healthy range for your age – measure it first thing in the morning, before getting out of bed. It will give you an indication of your levels of stress and cardiovascular issues.

Outcome and what it predicts

• Green zone – 60-70 bpm 5-7 mornings per week indicates lower long-term cardiovascular risk; better stress resilience; low risk of developing high blood pressure; and better long-term cognitive and emotional stability.
• Amber zone – 71-80 bpm 3-4 mornings per week indicates that your 60s is likely to involve a higher likelihood of chronic stress; higher chance of developing hypertension; and increased long-term cardiovascular risk (if the trend continues).
• Red zone – above 80 bpm 3 or more mornings per week indicates an even higher long-term risk of heart disease and stroke; higher likelihood of chronic stress; and greater risk of fatigue, burnout and emotional dysfunction over time.

Proactive steps

• Green zone – maintain a healthy lifestyle including regular physical activity (both aerobic and strength 2-3 times per week), consistent sleep habits and stress management routines (breathing, stretching and time outdoors).
• Amber zone – consistent sleep (bed and wake-up times); increase physical activity (1-2 extra sessions of light to moderate activity per week such as a daily 20 minute brisk walk, cycling or swimming); reduce alcohol intake (even small reductions help); stress management (breathing, stretching and time outdoors).
• Red zone – increase exercise and manage stress (see Amber zone); give priority to sleep quality; reduce alcohol and caffeine; consider discussing persistent high RHR with a GP.

Test 3: Perceived stress

This test involves a self-assessment of your stress level by applying a score of 0-2 to each of the following statements. You need to rate how often each statement has been true over the previous two weeks. A score of 0 = never; 1 = sometimes; and 2 = often. Then add up the total of all five items:

1. I’ve felt overloaded or under pressure.
2. I’ve found it hard to switch off mentally.
3. I’ve felt tense, wound‑up, or on edge.
4. I’ve felt that small things have irritated me more than usual.
5. I’ve felt tired in a way that rest didn’t fully fix.

Outcome and what it predicts

• Green zone – a score between 0 and 3 on one or less days per week means you’re managing stress well.
• Amber zone – a score of between 4 and 6 means on 2-3 days per week indicates you’re carrying a moderate stress load and small changes now can prevent chronic stress patterns.
• Red zone – a score of between 7 and 10 and 4-7 days per week means your stress level is high and indicates a high risk of burnout, mood problems and stress related physical health issues. In your 50s, high perceived stress is a strong predictor of poor health outcomes later in life. Your system is overloaded and more vulnerable to fatigue, poor sleep and emotional exhaustion.

Proactive steps

• Green zone – maintain routines that support calmness (walking, nature, hobbies); retain boundaries around work and personal time; maintain habits that keep stress low such a simple daily pauses and deep breathing.
• Amber zone – identify one or two sources of stress you can reduce; add daily relaxation practices; increase light physical activity; improve sleep consistency and strengthen social connections.
• Red zone – give priority to rest, sleep, and recovery; add structured daily relaxation (breathing, guided relaxation, stretching); reduce non‑essential commitments where possible; increase physical activity (such as walking, yoga). If the stress is persistent or overwhelming, discuss with your GP.

APPENDIX B

Physical health issues in our 50s

• Arthritis: signs often begin to show in the 50s – stiffness in the morning, aching joints after activity, some swelling and perhaps slightly reduced mobility. Osteoarthritis is the most common form, typically affecting knees, hips, hands or lower back. Management focuses on staying active – low-impact exercise like swimming or walking helps maintain joint mobility. Weight management, anti-infl updating some ammatory medications (like meloxicam), and occasional physiotherapy can reduce strain and improve comfort. See section 8.5 – Arthritis
• Bone health: Post-menopausal women and those with osteoporosis risk factors who have not had a bone density scan in their 50s should discuss this with their GP. Maintain calcium (1,200 mg/day) and vitamin D (800–1,000 units/day).
• Cardiovascular: It is important to maintain regular aerobic and strength-based exercise. Moderate-to-high intensity workouts are beneficial (section 2 – Exercise). It’s important to monitor blood pressure, cholesterol, and blood sugar annually (see section 7.3 and section 8.4).
• Cognitive changes: As we move through our 50s, mild memory lapses may begin and learning new information becomes harder, partly because of brain shrinkage and deteriorating connections between the neurons. This can result in slower recall and multitasking becoming more difficult.
• Diet, nutrition and hydration: Focus on nutrient-rich foods, fibre, lean protein and healthy fats. Aim for 6-8 cups per day of fluids. See section 2 – The vital role of diet and nutrition
• Eye tests: Once every 2 years or more often if vision deteriorates or risk of glaucoma (which has no early warning sign).
• Hearing: Testing advisable if hearing deteriorates
• Heart disease: See Cardiovascular above
• Hormonal changes: Postmenopausal and testosterone-related shifts may affect emotional well-being and metabolism. Nutrition, exercise, sleep, and stress management are all relevant for dealing with this. So is feeling engaged with life and connected to others, both of which are important factors in regulating stress hormones like cortisol.
• Injury management: Warm up and cool down before and after exercise. Soreness may reflect inflammation – use ice for the first 48 hours, then consider heat therapy. Both ice and heat should be applied for only 15 to 20 minutes and not again for one hour. Both should be applied through protective material to avoid skin damage.
• Muscular health: Maintain regular stretching, balancing and strengthening exercises, especially core and glute strength to support posture, and prevent back pain, and weight bearing exercises to slow muscle loss and support joint stability (see section 3 – Exercise)
• Osteoarthritis: See Arthritis above
• Osteoporosis: See Bone Health above
• Physical activity is essential for good health and, ironically, exercise will actually increase available energy for future use. This is because of the effect it has on your mitochondria – the tiny “batteries” in your cells that convert food into energy. Resistance or weight-bearing exercise strengthens those little batteries, and aerobic exercise (e.g. fast walking) will multiply the number of batteries (see section 3.4 – Exercise and mitochondria).
• Respiratory: Breathing problems, such as chronic bronchitis and emphysema, become more common, often undiagnosed until breathlessness starts to affect daily activities. Asthma may also worsen due to reduced lung elasticity. Screening involves lung function tests and symptom tracking. Vaccinations (flu and pneumococcal) are essential to reduce complications.
• Sleep quality: Sleep may become lighter and/or more fragmented. If ongoing tiredness, consider a sleep assessment to rule out apnoea or other disruptions (see section 6.1 – Sleep). If you feel more than tiredness, and it persists for more than 2 weeks, talk to your GP – it could be fatigue.

APPENDIX C

Disease & illness risks in our 50s

• Cancer: Screening for cancers such as bowel, breast, skin and prostate is very important when you get your 50s. Other cancers should be screened for if there is a family history, including pancreatic cancer (although the risk is low in the 50s). A variety of cancers and their early warning signs (if any) are included in section 8.2 – Conditions that require testing.
• Diabetes (Type 2): Risk increases significantly during the 50s so monitor blood sugar, particularly if you have a family history, if you start putting on weight or do not do regular exercise.
• Heart disease and stroke: Risk of heart failure, arrhythmias and vascular disease increases. Monitor symptoms of heart disease (breathlessness, swelling, etc); maintain healthy weight and avoid processed foods, smoking and excess alcohol. Annual cardiovascular review recommended if there are any risk factors: see section 7.3 – Early warning signs of heart problems – andsection 8.4 – Heart disease.
• Medication safety: Some people need to take multiple medications at the same time. This increases the risk of side effects and adverse interactions between drugs so, if they are prescribed by different doctors, it’s very important for your GP or pharmacist to review your medications periodically.
• Mental health: Career shifts, caregiving roles, and grief can affect emotional wellbeing. Depression, anxiety, and burnout can intensify due to life transitions, caregiving stress or hormonal changes.
• Osteoporosis becomes more common, especially for postmenopausal women. Bone density scans may be warranted. Management includes calcium, vitamin D, weight-bearing exercise and sometimes medication.