Feature Article of the Month

Your Health at Midlife: What You Need to Know

Life is a journey, filled with many passages and transitions. And midlife is one transition sure to get your attention. Many things may change—your relationships with your now—older children and your partner, your career, even your body. Some you can control; others you can't. One thing you can control, however, is your health during this time of life.

For once you hit midlife—and we're talking anywhere from your early 40s to early 50s—health-related issues you never before considered begin demanding attention.

Here, in a nutshell, are three things to focus on:

• Your bones. You've probably always taken them for granted, but now is the time to become aware of just what's holding you up—your bones. After menopause, you have far less estrogen available to maintain bone. Hence, bone-destroying cells get the upper hand, putting you at risk for osteoporosis. What to do? Ask your health care professional about your personal risk for osteoporosis. While bone density screening tests aren't usually recommended until 65, some health-related issues warrant earlier screening. Regardless of your risk factors, the following two approaches can help you maintain existing bone and continue to build bone:

  High levels of calcium. You should be getting at least 1,200 milligrams a day, but most women get only about 600 milligrams through their diet, so supplements like calcium citrate and calcium carbonate might be necessary. It's also important that you engage in some weight-bearing exercise most days, like walking, gardening or working out with weights.

• Your heart. Your biggest risk after you pass menopause is not breast cancer but heart disease. It's the leading cause of death in women over 45. Unfortunately, not enough women realize this. So if you haven't already, now is the time to really start paying attention to things like cholesterol levels, weight, physical activity and diet.

  Why now? Well, until now high levels of estrogen protected your heart, one reason women develop heart disease an average of 10 years later than men. However, as estrogen levels decline, so does that protection. While it's still not clear if supplemental estrogen can continue that protection, that's almost beside the point. If you're eating a heart-healthy diet composed of healthy fats, lots of fruits, vegetables and fiber, and low-fat protein like fish and soy, accompanied by at least 30 minutes of physical activity a day, you're well on your way to providing your body with what it needs to replace the previous protection of estrogen.

  Oh yeah—and stop smoking. If you smoke, you're two to six times more likely to suffer a heart attack than a nonsmoking woman, and your risk increases with the number of cigarettes you smoke each day. You also have a significantly higher risk of heart disease if you have diabetes, high blood pressure or high cholesterol or if you are obese and/or have low levels of physical activity.

• Your blood sugar. You can't feel it or taste it, but if your blood sugar levels start to creep up, you're putting yourself at increased risk for everything from heart and kidney disease to dementia, nerve damage and early death. You don't even have to be officially diagnosed with diabetes to find yourself in trouble. A condition called "insulin resistance," in which your cells prevent insulin from "unlocking" the door so energy in the form of glucose can enter, also increases your risk of heart disease, as does full-blown diabetes.

  The remedy? Watch your diet, get regular physical activity and try to maintain a healthy weight—nothing new here. And if you're 45 and older, make sure you're getting regular blood sugar tests at least every three years. Your health care professional may want to test you more often depending on your risk factors for developing diabetes. Also measure your waist every few months. A high waist-to-hip ratio increases your risk of insulin resistance and diabetes.

Of course, these three areas aren't the only things you need to think about. You also want to make sure you:

• Have an annual mammogram from age 40 onward.

• Have a Pap test for cervical cancer every one to three years, depending on your risk factors and previous results.

• Have your blood pressure tested at least once a year.

• Have your cholesterol tested at least every five years (more frequently if you have risk factors for heart disease).

• Begin colorectal cancer screenings at age 50.

• Have regular dental exams and every-six-month tooth cleanings.

• Get a complete eye exam at least every two to four years, more often depending on your personal or family medical history.

• Get an annual skin exam for skin cancer.

Do all these, and you're much more likely to enjoy the next 30, 40 or 50 years as much as the past 30, 40 or 50.

References

Wright JD, Wang CY, Kennedy-Stephenson J, Ervin RB. Dietary intake of ten key nutrients for public health, United States:1999-2000. Adv Data 2003 Apr 17;(334):1-4.

National Heart Association: Heart Disease and Stroke Statistics — 2006 Update.

Heart Disease and Women: Kicking the Smoking Habit. National Heart, Lung, and Blood Institute. August 1995.

Misra D. Ed., the Women's health Data Book: A profile of Women's health in the United States, 3rd edition. Washington, DC: Jacobs Institute of Women's Health and The Henry J. Kaiser Family Foundation, 2001.

MMWR, Nov. 7, 2003. Self-reported Heart Disease and Stroke among Adults with and without diabetes — United States, 1999—2001.

Jawa A, Kcomt J, Fonseca VA. Diabetic nephropathy and retinopathy. Med Clin North Am. 2004 Jul;88(4):1001—36, xi. Review.

"Diabetes In America," 2nd edition, National Diabetes Data Group, National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases. NIH Publication No. 95—1468 1995.

This project funded by an educational grant from Solvay Pharmaceuticals, Inc.

Create Date: 6/1/2006