Who doesn’t want a long and healthy life? Ageing may be non negotiable but how you do it affords some wiggle room. There is, however, no time to lose. Ideally you’d have been getting your health in order before middle age. But it’s never too late to start. Each of us has a chronological age that’s measured in birthday candles. Since every person ages differently we also have a biological age that reflects how old our body really is. This age depends on the relationship between our genes, lifestyle and living conditions. It’s this biological age you can change by doing what I’m about to tell you.
Be positive about it
Over 80% of people say they feel younger than their age. Largely because most societies view ageing negatively, says Dr Serena Sabatini, postdoctoral research associate at the Università della Svizzera Italiana. Her research shows that people who have good role models for ageing, such as active grandparents, age better themselves. “They are less likely to be anxious and more likely to be engaged in life and follow a healthier diet,” says Sabatini. “When people feel more negative about ageing they do little to keep being healthy so they age in a less graceful way.” Personality traits also come into it. “Being more open means you are likely to feel more positive about ageing,” says Sabatini.
My mum, at 98 years old, with no short-term memory, feels positive about her age when reminded of it. “Only two years to go before I’m 100. It’s better than not being around.”
“Inflammageing” is what happens to the body as our cells get damaged with age. The end result is chronic inflammation and a batch of health problems. Studies show consistent results in which diets protect us, says Dr Stacey Lockyer, senior nutrition scientist at the British Nutrition Foundation. “Healthy plant-rich dietary patterns, such as the Mediterranean-style diet and the Dietary Approaches to Stop Hypertension (DASH) diet, are associated with reductions in risk of heart disease, type 2 diabetes and some cancers, as well as death from all causes. These diets all have a high intake of plant foods with fruits and vegetables, wholegrain foods, protein including plant-based proteins (pulses, nuts) as well as some fish, seafood, poultry, lean meat and lower-fat dairy products (or dairy alternatives).” These diets eschew processed meat and foods high in saturated fat, sugar and salt (cakes and crisps).
For those of us with a family history of dementia (me) there’s evidence that these diets can also delay cognitive decline by several years.
Don’t bother with supplements
A well-balanced diet means that you don’t need supplements. However, Lockyer points out that the lack of sun in UK winters has prompted the government to suggest we “consider” daily vitamin D supplements of 10µg from October to March. Vitamin D is needed for bone and muscle health – essential for everything except sitting, which you shouldn’t be doing anyway.
Maybe lose a bit of weight
Lockyer says that if you are obese, “even losing 3% of your body weight can be beneficial in reducing your risk of developing serious diseases”. She advises smaller portions rather than drastic diets. “Weight control is even more significant for Black, Asian and other minority ethnic groups,” Lockyer explains. “They have a higher risk of serious health conditions, such as type 2 diabetes at a lower BMI and waist circumference measurements than the white population.”
Don’t focus on ‘superfoods’
When it comes to superfoods, strawberries and blueberries are fan favourites – credited with antioxidant and anti-inflammatory properties. Ayela Spiro, nutrition science manager at the British Nutrition Foundation warns that the evidence is inconclusive. “People who consume berries may also have many other positive health-related dietary and lifestyle behaviours, which themselves are associated with healthier ageing,” she explains. “The message remains to eat a varied, plant-rich diet.”
My 98-year-old mum is partial to blueberries.
Exercise like you mean it
It’s all about exercise. It lowers blood pressure and reduces the risk of obesity, diabetes and heart disease. If you’ve been clocking up 150 minutes of exercise a week (on 4-5 days) since your 20s then congratulations. Don’t stop. “People need to consider exercise as part of their personal hygiene, like brushing your teeth, not something to ‘add on’ as an afterthought,” says Professor Benjamin D Levine, who holds a distinguished professorship in exercise sciences at the University of Texas Southwestern Medical Center. His research shows shows that exercise training, started in middle age, can reverse the stiffness in the heart muscle that can cause heart failure.
Out of the 4-5 days of exercise, one day should be a high-intensity workout (up to 95% peak heart rate), two or three should make you sweat and one can be less strenuous such as tennis the way I play it. Levine says 30 minutes of brisk walking five times a week will also do the job.
Resistance is the opposite of futile
“Resistance training is important to preserve strength, balance and functional capacity as we age,” says Levine. “It doesn’t have to be pumping iron in the gym though. Pilates, strength yoga, tai chi – there are lots of ways to improve strength. Flexibility is much harder to improve, though I don’t think that by itself it has a major impact on mortality, cardiovascular disease or even musculoskeletal injury.”
Duh! Does it even need saying? Although you could biologically age even faster by smoking while sitting down.
Manage the menopause
“Menopause is the marker of middle age – just experiencing it makes women feel older,” says Sabatini. But does the cruel loss of oestrogen speed up biological ageing? Perhaps a small amount. Steve Horvath, professor of human genetics and biostatistics at UCLA, says it’s nothing to be alarmed about. “As a reference group, consider men. Men are at a substantially higher risk of mortality than women irrespective of menopausal status.”
Menopause does speed up bone loss and increases the risk of heart disease, but stocking up on calcium (milk, cheese) and vitamin D in the diet (two portions of fish a week, one of them oily) and cutting down on saturated fat and salt can reduce the risk of osteoporosis and cardiovascular disease.
The National Institute for Health and Care Excellence’s view on the use of HRT to alleviate menopausal symptoms is that it’s an individual’s decision to make based on their views of the risks and how horrible they feel.
Feeling lonely in middle age does not set you up for healthy ageing. Especially if you’re a man. The studies aren’t clear why loneliness increases the risk of dementia, heart disease and depression. You can be with a group of people and still feel lonely. Mind has tips on how to manage loneliness which include volunteering and joining groups based on your hobbies.
Take up a hobby or language
Healthy ageing requires mental as well as physical activity. Artistic hobbies in particular such as painting, sculpture or pottery may help memory and thinking. But anything that exercises your brain, such as Wordle, is beneficial. There’s some evidence that learning a second language can boost neuron activity in the brain and keep you mentally sharp.
It’s a myth that as you get older you need less sleep. “But it’s a common thought that older people sleep less and so once people start sleeping poorly they feel old,” says Sabatini. “Poor sleep is related to poor cognitive function, depression and anxiety. It impacts on how people feel about themselves.” Don’t ignore pain or medical conditions that can impact sleep because you’re blaming your age. “Mindfulness and bedroom routines can help improve sleep,” says Sabatini.
Look after your skin
Dr Bav Shergill, of the British Association of Dermatologists, says that ageing in the face follows a pattern. “The first sign is wherever you have movement – the lines start staying there without movement. Your face loses volume, you get a tiny pre-jowl, and your cheeks shrink a bit. We lose elastin so we look more tired. People may not mind looking older but they don’t want to look tired.”
Avoid sun damage, which makes skin look thick, wrinkled and discoloured. Smoking is even more damaging. On the plus side, Shergill says that vitamin A topical products work. But for prescription-level treatments such as retinoic acid, you need to invest in a private dermatologist – not that he’s advising that. He administers Botox on the grounds it’s reliable and wears off. “Lines that get ingrained across your forehead can make you look angry. Botox can open up your face, but you still want to be able to express delight – to move your eyebrows.”
It’s the elephant in this article. Dr Darío Moreno-Agostino, research fellow in population mental health at King’s College London, says research shows that more money gives you a better health trajectory as you age. Dr Gemma Spiers, senior research associate at the National Institute for Health and Care Research’s Older People and Frailty Policy Research Unit at Newcastle University, agrees: “The richer have more years of disease-free life expectancy. If you ask someone to eat a bit healthier or take more exercise, that comes at a cost.”
• Dr Luisa Dillner is head of research and product development at the BMJ.