One Australian woman dies from heart disease every hour, making it the leading cause of death for women. Whatever your age, you can use this advice to lower your risk and keep your heart healthy.
Follow a heart-healthy diet. That means a diet low in saturated fat and rich in fruits and vegetables, whole grains and nuts. "Portion sizes are important, too," says Nakela L. Cook, chief of staff in the Office of the Director at the National Heart, Lung, and Blood Institute. The heart-healthy DASH diet—which stands for Dietary Approaches to Stop Hypertension—is promoted as an effective way to reduce blood pressure and stay at a healthy weight.
Increase your physical activity. Aim for 30 minutes a day most days of the week, advises Cook. "Even if you do small increments of activity that get your heart beating faster, like 10 minutes here and there three or more times a day, it will have an impact on your cardiovascular health," she says.
Take steps to combat stress. "This tends to be one of the busiest decades in women's lives," says cardiologist Dr Christine Jellis. "Many women are working full-time, might have young children, might be caring for older relatives. It's easy to forget about our own health." People dealing with high levels of stress often don't have time for adequate sleep, relaxation, exercise or healthy eating, she explains—all of which are important for keeping the heart healthy.
Make sure you have a skilled primary care provider. Talk with a doctor about your individual risk factors, including family history, and get advice for developing a heart-healthy lifestyle going forward. If you had high blood pressure or diabetes while pregnant, make sure your doctor continues to monitor those issues; they can increase the risk of cardiovascular disease later.
Know your numbers. Get baseline screenings for blood pressure, cholesterol, weight, and BMI. Your risk of heart disease in your 40s is still relatively low, but undergoing hormone therapy or smoking and taking oral contraceptives increase that risk.
Focus even more on diet and exercise. "This is a decade when women tend to gain weight," says Cook. If you aren't monitoring it, weight can creep up slowly until the time comes when you have to make drastic changes. Paying attention now can head off a more serious problem later.
Talk to a health care provider about the pros and cons of oestrogen therapy. "Taking hormone therapy as a primary way of preventing heart disease is not recommended," says Cook. "But we are starting to learn more about how oestrogen can protect women's hearts at different times in their lives."
Ask your doctor about vitamin D. New research is looking at whether vitamin D supplementation can reduce the risk of heart disease. Although results aren't in yet, many doctors believe that vitamin D—which the body absorbs from food and produces after exposure to sunlight—plays a vital role in overall health and heart health and that it's important not to let your level get low. "A lot of people living in northern regions don't get adequate sun exposure and are deficient in vitamin D," says Jellis. "Ask for a blood test to check your level, and consider supplements if your doctor finds your level is low."
Keep an eye on your numbers. Have your blood pressure, cholesterol, weight, and BMI checked at least annually to make sure your risk factors stay low. (Make sure you're getting these 5 blood tests if you're over the age of 50.)
Limit the salt in your diet. Even if you've never had high blood pressure, now is a good time to take steps to keep it in check, such as reducing your salt intake. "As people get older, the artery walls get stiffer, which increases the risk of hypertension," explains Jellis. "People who don't have a history of it may develop it because of this increased stiffness." She adds that other medical problems that become more common with age, such as diabetes and kidney disease, also make high blood pressure more likely.
Consider nutritional supplements. "A well-balanced diet is ideal," says Jellis, "but if you aren't eating well, it's smart to discuss vitamin or mineral supplements with your doctor." Just as important as what you do eat is what you don't. Besides salt, try to minimise your intake of sugar, which can raise blood glucose and saturated fat, which can raise cholesterol levels.
Ask your doctor about daily aspirin. "Aspirin is recommended when the potential benefit seems to outweigh the side effects, and after age 65 is the right time for women to have that conversation," says Cook. Daily aspirin may help prevent heart attacks and strokes caused by blood clots, but possible side effects include gastrointestinal bleeding (possibly leading to a stomach ulcer) and increased risk of a hemorrhagic (bleeding) stroke.
Pay attention to symptoms. Chest pain or discomfort is the major sign of a heart attack, but women may also experience less-typical symptoms such as shortness of breath or back pain. "Jaw pain, nausea, increased fatigue—all can be atypical symptoms of coronary artery disease," says Jellis. "Listen to your body and seek an evaluation if you're concerned so you don't delay getting diagnosed."
"Bone is a dynamic tissue," explains Andrea Singer, clinical director of the National Osteoporosis Foundation. "Old bone is constantly being broken down and replaced with new bone." Until your 40s, the rates of breakdown and formation are relatively balanced; after that, bone loss exceeds the rate of new growth. While you can never regain the peak bone mass of your earlier years, you can significantly slow the loss, Singer says. These strategies can help.
Know your osteoporosis risk. Your odds of developing the condition are determined by a variety of factors, so it's important to talk with your doctor about any circumstances in your life that could accelerate your bone loss. Family history and the level of peak bone mass you built in your youth have a major effect on your risk, but so do certain illnesses and medications. "Conditions such as rheumatoid arthritis, celiac disease and Crohn's disease can speed bone loss, as can medications such as corticosteroids," says Wayne Johnson, a spokesperson for the American Academy of Orthopaedic Surgeons. Race is also a factor: Women of Caucasian and Asian descent have the greatest risk.
Focus on calcium and vitamin D. The two work in tandem to protect your bones: Calcium helps build them and slows the rate of loss, while vitamin D helps your body absorb calcium. "Getting enough of both is essential to keeping your bones strong and healthy as you age, but, unfortunately, too many people fall short," Singer says.
Women in their 40s should get 1,000 mg of calcium a day, ideally from foods such as yogurt, milk, fatty fish like salmon, and leafy green vegetables. "As long as you're eating three or four of these foods each day, you're probably getting enough calcium," Johnson says. If you suspect you aren't getting enough, talk with your doctor about taking a supplement.
Vitamin D, on the other hand, is difficult to get from diet alone because few foods contain it (fish, eggs, and fortified products such as milk and cereal are good sources). You can get some or all of the 600 IU you need daily from sun exposure, but because so many factors (such as sunscreen use and season) can interfere with the process, it's not a reliable source. If your diet doesn't include vitamin D-rich foods, you don't get outdoors often, or you wear sunscreen when you go outside, ask your doctor whether you should have your vitamin D level tested to see if you would benefit from a supplement.
Choose bone-strengthening exercises. Strength training using a set of weights or just your body weight and weight-bearing exercises such as walking, jogging, and stair climbing are the best activities for protecting your bones, Johnson says. These moves put stress on your skeleton, which causes new bone tissue to form. It is recommended that women do 30 minutes of weight-bearing exercise four or more days a week, along with at least two strength-training sessions, for optimal bone health.
Boost your calcium intake. The requirement is higher in this decade: Women ages 51 and older need 1,200 mg daily (up from 1,000 mg for younger women). It's best to get calcium through diet if possible (see advice on the previous page). It's also wise to limit your intake of alcohol, salt, and caffeine, since all three can speed bone loss, Singer says.
Follow a low-inflammatory diet. Add "stronger bones" to the many benefits of anti-inflammatory eating plans such as the Mediterranean diet. A 2017 Journal of Bone and Mineral Research study of women ages 50 to 79 found that those with the least inflammatory diets—high in fish, fruits, vegetables, and whole grains—lost less bone density over 6 years than women with the most inflammatory diets.
Ask your doctor about bone-density testing. It is recommended that all women have their bone mass measured at age 65, but your doctor may advise you to get tested now if you have risk factors. These include a recent fracture, a height loss of 1/2 inch or more within 1 year, or a total height loss of 2 1/2 inches from your original height. Women with certain lifestyle factors, such as alcohol abuse, smoking, or prolonged physical inactivity, may also need to be tested earlier, since they're at greater risk of developing osteoporosis or its precursor, osteopenia, at a younger age, Johnson says.
Get a bone-density test. All women 65 and older should have their bone density measured. If the test shows you do have low bone mass, it doesn't mean you'll necessarily develop osteoporosis or break a bone. But it does place you at a higher risk and gives your doctor an opportunity to help you head it off. "Depending on how advanced your bone loss is, your doctor may recommend medication to help slow or stop it or to rebuild bone," Singer says.
Minimise your risk of falling. About 1 in 3 people over 65 fall each year, and many of these falls result in broken bones. A few simple steps can prevent them, Singer says: Wear shoes with nonslip soles indoors, remove throw rugs that you could easily trip over, keep hallways and corners well lit, and take extra care with medications that can affect your balance or make you drowsy.
Reevaluate your exercise routine. Singer and Johnson recommend having a discussion with your doctor about which types of exercise are safest for you now. Low-impact activities such as walking and swimming are a better option than high-impact activities, particularly if you have musculoskeletal conditions such as arthritis. "This is also a good time to try tai chi or yoga," Johnson says. "Both can help maintain or improve your balance so you're less likely to fall."
They're windows on the world, but as we age, our eyes change in ways that are nearly universal: We have problems with close-up vision in our 40s, dry eyes in our 50s, and night and colour vision later on. "And everyone will get a cataract at some point," says ophthalmologist Stephanie J. Marioneaux. Not all problems are preventable, but you can follow this advice to help keep those windows clear.
Eat for eye health. There's no way to head off presbyopia, the hardening of the lenses that naturally happens with age and leads to difficulty seeing things up close. But you can protect your vision in other ways through your diet, says Christopher J. Quinn, president of the American Optometric Association. "Eye-friendly nutrients including lutein, zeaxanthin, vitamins C and E, essential fatty acids, and zinc may reduce your risk of developing certain eye diseases such as macular degeneration," he explains. Get them from foods such as fish, eggs, nuts, and brightly colored vegetables.
Consider visiting an ophthalmologist. You've most likely been getting eye exams from an optometrist until now, and that's perfectly fine: Optometrists are trained to perform eye exams and treat vision changes with glasses and contact lenses and can diagnose and treat some eye conditions and diseases. But if you have a family history of eye disease or suffer from certain conditions like diabetes or high blood pressure, you may want to make an appointment with an ophthalmologist—a medical doctor who specialises in surgical eye care and can diagnose and treat eye diseases. After an evaluation, your doctor will determine your risk factors and set a follow-up schedule that's appropriate for you.
Choose sunglasses wisely. If you've been selecting them based on fashion rather than function, now is the time to make the quality of the lenses as important as the look. "Cumulative exposure to UV rays puts people at greater risk of premature eye aging and vision disorders, so it's important to wear good-quality sunglasses year-round," Quinn says. Look for ones that block UVA and UVB radiation and screen out 75 to 90% of visible light.
Don't rely on over-the-counter eyedrops. Most people have a feeling of dry eyes occasionally, but chronic redness, burning, and grittiness are signs of dry eye disease. Having chronically dry eyes is associated with estrogen decline and happens more frequently after menopause. Over-the-counter eyedrops may not always provide sufficient relief.
"Dry eye disease is actually very complex, and there's no quick fix for it," Marioneaux says. The severity of dry eye symptoms doesn't always correlate with the stage of the disease, so you could have a more advanced stage than you realise. In addition, the causes can vary, from inadequate tear production to poor-quality tears that evaporate too quickly. So it's important to be evaluated by an eye doctor, who can prescribe drops that target your particular dryness issue.
Be savvy about screen time. Spending long hours looking at a TV, computer, tablet, or smartphone is another major contributor to dry eye disease. "We suppress our natural urge to blink when we're staring at electronic screens, which dries out the surface of the eyes," Marioneaux explains. The National Eye Institute recommends taking periodic breaks from screens to close your eyes for a few minutes or blink repeatedly, which helps replenish tears and spread them more evenly across your eyes.
Keep your weight in check. Dropping extra kilosb helps reduce your risk of heart disease and diabetes, both of which can impair vision—and in the case of diabetes, may even lead to blindness—by damaging the tiny blood vessels in the eye. "Eye doctors can see these changes during an exam, which is another reason it's so important to get regular checkups," Marioneaux says.
See an ophthalmologist or optometrist annually. As you get older, your risk of eye disease increases. After age 65, it's crucial to have your eyes checked yearly, whether you're experiencing vision changes or not. "Many conditions can be detected at an early stage before they cause symptoms, and a prompt diagnosis means better treatment options that can help reduce your risk of vision loss," says Quinn.
Brighten your surroundings. Don't be surprised if the lighting in your home seems dimmer now: Less light reaches your retinas as you age, so older adults typically require extra lighting, Quinn explains. When using a table lamp or floor lamp, place it to your left side if you're right-handed and to your right if you're left-handed—this reduces glare and minimises shadows. Consider adding night-lights and glowing light switches to help you navigate if you get up in the middle of the night.
Take extra caution behind the wheel. Driving often becomes more challenging after age 60, when age-related vision changes and eye diseases may interfere with your ability to see road signs clearly or to see in low light or at night. It may also take longer to adapt to the glare of sunlight and headlights. To stay safe, it is advised to take extra care at intersections, where many accidents involving older drivers occur because of a failure to yield, particularly when making a left turn. Also smart: Limit yourself to day driving when possible, reduce your speed, and avoid glasses with wide frames that could impede your side vision.