When I was just 28, part of my work as a doctor was organising care for the elderly. And that’s when I first noticed something rather strange.
Some people in their 80s were very disabled and dependent on others, while others were lively characters who still worked, made love, drove cars and cared for others.
‘What made the difference?’ I asked myself. Was it just luck — or did it have anything to do with the choices each person had made?
Don’t look at mid-life — the years between 40 and 60 — as the beginning of the end
When I discussed this with my elderly patients, I realised that a few of them had contracted diseases that no one could have prevented. In short, they’d had bad luck.
But it was equally clear that many of them had greatly raised the likelihood that they’d suffer from diseases in later life by not paying sufficient attention to their health in mid-life.
Indeed, as the years have gone by, scientific evidence for this has become overwhelming. Many diseases, including dementia, can be prevented or postponed by actions taken in mid-life.
True, some diseases may be due to your genes — but far fewer than you’d think. It’s estimated that genetics are responsible for no more than one-fifth of common diseases.
In other words, an incredible four-fifths of diseases are preventable in men and women.
So it’s time to stop looking at mid-life — by which I mean anything between 40 and 60 — as the beginning of the end. Instead, we need to view it as the end of the beginning.
And above all, we owe it to ourselves to change our bad habits, so we have a far greater chance of a healthy, active and disease-free old age.
Yet many people reach mid-life and assume it’s natural to lose fitness, gain weight and find they’ve suddenly developed high blood pressure or type 2 diabetes.
Unfortunately, that’s all too likely. By the age of 40, roughly one-third of the UK population has been diagnosed with a chronic health problem. By 50, half of us have one. By 60, roughly two-thirds have at least one long-term health condition. This is profoundly shocking because, to a large degree, it’s avoidable.
So over the next few days, I’ll be giving you all the latest and most scientifically sound advice on how to stack the odds in your favour for a healthy mid-life and old age.
Even if you have one or two long-term health problems, the changes I’ll be recommending will radically improve your chances.
First, let’s check the state of your own health. Just put a ring around the number closest to the description most appropriate to you in each case (ring number one if you’re in tip-top form down to number five if you’re the opposite):
Full of beans 1 2 3 4 5 Feel really tired
Can run a mile 1 2 3 4 5 Couldn’t catch a bus
Feel very calm 1 2 3 4 5 Very wound up
Sleep soundly 1 2 3 4 5 Sleepless nights
Lean and mean 1 2 3 4 5 Fat and flabby
Over the moon 1 2 3 4 5 Down in the dumps
If you scored a total of:
Six — that’s great. Even 12 or less shows that you’re doing well.
13 to 20 — you’re not doing badly. But by taking action, you could not only feel better but reduce the risk of long-term health problems.
20 or more — don’t despair. The good news is that the steps you take to reduce your risks of disease in the long term will help you feel better within a month.
The key is to look at mid-life as the time for action. When you’re under 40, you can get away with abusing your body to a certain extent, but after that, you really need to make an effort.
Otherwise, a huge gap will open up between how able you are and how able you would have been if you’d kept fit. This is called the fitness gap.
Yet by taking action in mid-life, you can become as fit as you were ten years ago and live much better for longer.
Perhaps you’re one of the many who assume all the bad things that happen in later life are due to getting older. The truth, however, is that ageing is relatively unimportant.
Yes, it does have an effect on many body tissues and organs. For instance, the maximum heart rate drops by about one beat per minute every year from 35, which is why there are very few world-class athletes past this age.
Ageing also affects your resilience. One example is that your body loses some of its ability to respond when you lose your balance, which makes you more likely to fall.
However, your main enemies aren’t anything to do with ageing — they’re a bad diet, lack of fitness, lack of sleep and too much harmful stress.
To those, I’d add one more important factor: as youth retreats, many people allow themselves to become negative and pessimistic. Research has shown they develop a fatalistic attitude to the years ahead. This is perfectly understandable. They face so many pressures and deadlines in the here and now that looking after themselves has become a low priority.
Yet by burying their heads in the sand, those people are almost inviting calamity.
So, let’s try pitching our minds ahead to old age. Which of the following phrases do you identify with most strongly?
I hope to drop dead suddenly.
I hope I don’t develop dementia.
I hope I won’t be disabled and a burden on my family.
I hope I can stay pretty fit until pretty near the end.
Dropping dead suddenly on the last day of a wonderful holiday may seem like a great way to go, but it has its downside.
It can be very tough for those left behind. In any case, if you don’t look after yourself, you may not be fit enough to go on holiday in the first place.
As for suffering from dementia or being so disabled that you need someone to look after you — well, no one wants that.
Being stuck in a chair and unable to get to the lavatory in time is certainly a miserable prospect. But if you do nothing to improve your lifestyle in mid-life, the chances are that’s roughly how you will end up.
You’ll suffer from a progressive loss of fitness, complicated by the development of one or more disabling diseases — all because you haven’t bothered to reduce your risk.
The choice is yours. And it really isn’t that hard to recharge your life. You don’t need to work out every day, go vegan or become teetotal.
Over the next few days, I’ll be showing you how to change your destiny by tackling harmful stress and improving your diet, your fitness and the quality of your sleep.
But let’s start with your body in mid-life.
TEETH AND GUMS
From the age of 40, you need to focus more on your gums. Unless you start to look after them obsessively, your teeth are doomed.
How to ward off Alzheimer’s
The one disease that most people fear even more than cancer is dementia — yet you can do a lot to lessen your risk of contracting it.
Many people develop dementia simply because the blood vessels to the brain become narrowed by atherosclerosis — or when plaque builds up inside them.
When a big artery in the brain is affected, you may end up having a stroke. Alternatively, if lots of small arteries are progressively narrowed and blocked, you may get dementia. The solution? A better diet and level of fitness from mid-life onwards. Physical activity — the more vigorous, the better — has a particularly beneficial effect: it keeps the blood vessels to the brain healthy by preventing inflammation.
The evidence is clear. NICE, the National Institute for Health Care and Excellence, which reviews all the scientific evidence and advises the NHS on what works and what doesn’t, is emphatic that it is possible to ‘delay or prevent the onset of dementia, disability and frailty’ by taking action in midlife.
Even healthy teeth will eventually fall out of gums that haven’t been properly looked after. So you need to take extra care.
First, remember that sugar is just as damaging to adult teeth as it is to those of children. Therefore, you should eat as little sugar as you can, as few times a day as possible.
Sugar in fruit can be just as bad as the refined sugar in a cake or chocolate bar. So if you eat grapes or a banana between meals, try to clean some of the surplus sugar off the surface of your teeth. Even a mini-gargle with water is helpful.
Try sticking to three meals a day. And forget about brushing just twice a day: you need to clean your teeth after each meal.
Again, if you can’t, just rinse out your mouth with water.
Some dentists also recommend sugarless chewing gum because it cruises around the mouth, picking up any crumbs that would lead to plaque.
Now, let’s look at your night-time brushing ritual — the most important one of the day. You need to spend at least five minutes on this.
Are you relying on an electric toothbrush to do everything? Well, don’t: the rotation of the bristles usually buffs only the surface of the teeth. Here’s what you need to do as well:
Use a special little pointy brush, called an interspace brush, to clean between your teeth, taking about a minute to go round the top and bottom. Push it up and down hard on the line where the gums meet the teeth.
Next, use dental floss — not in and out, but up and down between the teeth. Press down on the gum.
Now use a special little brush, called an interdental brush, to push through the junctions between teeth and gums.
Then use an old-fashioned manual toothbrush for another attack on the junction between tooth and gum. Focus particularly on the lower teeth because plaque grows faster there. Brush downwards on both the insides and the outsides of the teeth.
Finally, polish the teeth surface with an electric toothbrush.
It won’t be five minutes wasted, I promise. And you can get even better value out of this time by standing on one leg throughout — good for maintaining crucial balancing skills well into old age.
Your skin betrays the most obvious signs of ageing, so take care of it. Women are better at doing this than men, but sometimes they spend far too much on ineffective designer creams.
For both sexes, there are a few simple rules:
There’s no strong scientific evidence that anything labelled as ‘anti-ageing’ has any significant effect on your skin.
Use a simple, inexpensive aqueous cream liberally, all over. Try to moisturise every day, or at least once a week.
Protect your skin from excessive ultraviolet light from the sun. Use strong sun protection — and take vitamin D every a day to compensate for the fact that the suncream stops your skin making enough of this vitamin.
Stop smoking — it reduces blood flow to your skin, making you look older.
Excessive alcohol will dehydrate your skin, leaving you looking older and tired.
Drinking water will prevent your skin from drying out.
HEART AND BLOOD VESSELS
Disease of the heart and blood vessels is the No. 1 killer. And there are four factors that increase your likelihood of contracting it:
High blood pressure.
High blood sugar — also known as type 2 diabetes.
High levels of cholesterol.
If one or more of these applies to you, then you may be offered a drug to control it. But beware: unless your levels of cholesterol, blood sugar or blood pressure are extremely high, it’s often better not to medicate at all.
Try asking your doctor this: ‘What additional risk would I run if I postponed starting the drug treatment for a year — and instead sorted out my diet, weight and fitness?’ The truth is that it’s always best to alter your diet and improve your fitness before considering any drug treatment for such conditions.
Not only will you feel markedly better, but your health should dramatically improve.
There’s one exception to this rule. If your father, or one or more other relatives, died of a heart attack before the age of 50, you should ask for a genetic test. You may possibly have a rare disorder called familial hypercholesterolaemia.
Ever feel a bit short of breath? Getting fitter will not only increase your mental well-being, but will also help you feel less breathless.
This is because being fit increases the ability of your muscles to suck oxygen from the blood that’s passing through them — rather than relying on oxygen directly from the lungs themselves.
But you can be super-fit and still struggle for breath if you live in a city affected by air pollution — particularly by the nitrogen dioxide that comes from diesel engines.
Ideally, all diesel engines should be banned. But if you can’t avoid city centre air, you should:
Monitor air pollution via an app on your phone and try to avoid smog spots on days when levels are particularly high.
Avoid busy streets with tall buildings on either side.
Walk on the inside of the pavement, not the kerb.
Keep car windows shut — above all, don’t allow outside air into the car while driving on busy streets.
Eat fresh fruit, vegetables and whole grains, which may offer some protection against the harmful effects of pollutants.
GUT, BOWELS AND LIVER
Around 40 per cent of people have at least one digestive symptom at any one time. The most common ones are:
Changes in bowel movement (constipation or diarrhoea).
These can usually be treated with improved diet and exercise. Medicine from the chemist’s should only ever be a short-term fix. If symptoms persist, see your GP.
Otherwise, these five tips should alleviate most problems:
Eat a Mediterranean diet to keep gut and bowels in good order.
Fill up on fibre — for a healthy bowel, you need fibre from a variety of sources (wholemeal bread, fruit, vegetables, beans and oats).
Drink plenty of fluid to aid your digestion.
Try to avoid too much spice as this can upset your stomach.
Drink less alcohol — and, from the age of 50, have at least two alcohol-free days a week.
BONES, JOINTS AND MUSCLES
Every exercise that makes your muscles stronger will strengthen your bones, and every exercise that strengthens your muscles will help them support your joints better.
For the joints, however, the most important aspect of fitness is suppleness. From the age of 40 onwards, you need a short daily routine built on the principles of one of the four great suppleness programmes: yoga, tai chi, Pilates or the Alexander technique.
Women should also drink a pint of milk a day, or eat enough calcium-rich foods to compensate.
Pack it in: Whether it’s cigarettes, cigars or pipe smoking, they are all bad for you
My advice is simple: Stop. Even if you’ve tried before — once, twice or even 20 times — please try again. Here are the top ten benefits:
1. You’ll breathe easier — your lung capacity will improve by 10 per cent in the first nine months and you’ll cough a lot less.
2. You’ll have more energy — within two to 12 weeks, blood circulation will improve dramatically.
3. You’ll be less stressed — studies show that levels greatly decrease.
4. You’ll have better sex. Men get better erections and women not only have better orgasms, but find it easier to become aroused.
5. You’ll be more fertile — chances of conceiving a child will increase.
6. Your senses of smell and taste will improve.
7. You’ll look younger because the skin of non-smokers receives more nutrients and oxygen.
8. Your teeth will be whiter — tobacco smoke stains teeth. You’ll also have fresher breath.
9. You’ll live longer — half of all long-term smokers die before their time from smoking-related diseases (heart disease, lung cancer and chronic bronchitis).
10. You’ll protect your loved ones — studies show that second-hand smoke is seriously dangerous.
Ready to have another go? You’re four times more likely to quit by using the NHS Stop Smoking service (see NHS Choices online).
Make an appointment with an adviser who’ll offer advice, support and — if necessary — drugs to reduce your cravings. Or go to see your GP.
For some people, e-cigarettes have been helpful, but taking any new chemical into your body should be done with caution. No one yet knows the long-term effects of using e-cigarettes.
Adapted from Midlife: Live Longer, Look Younger, Feel Better by Muir Gray (Century, £10.99). © Muir Gray 2016.
To order your copy for just £8.24 (offer valid to January 10, 2017), visit mailbookshop.co.uk or call 0844 571 0640. P&P is free on orders over £15.