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The Age of Change
Stay healthy and fit as you age through your 20s to your 50s.
By Cynthia BeMent
It may be inevitable, but aging doesn’t have to send your health into a no-brakes downhill spiral. A little knowledge about what’s happening to your body as decades go by can help you build yours to resist age-related diseases, shun fat and stay strong at any age. Read on for your guide to managing your health and your weight from your 20s through your 50s.
20s
What’s happening: Metabolism
In your 20s, your metabolism’s still fueling your physical development; you may have stopped getting taller, but your body’s not done growing yet. "In your 20s you’re still building," says Samantha Heller, M.S., R.D., a clinical nutritionist at New York University Medical Center. "Your bone and muscle mass are increasing; your metabolism hasn’t started to calm down yet." With your body in overdrive, less-than-sterling health habits may not produce immediate effects on your weight or your health. But this is the time when you’re building your body’s momentum for the rest of your life. 
Potential health challenges
As adulthood gathers steam, realities like long work hours, fast food lunches and late-night socializing can challenge good nutrition and exercise patterns. But cementing those patterns now not only increases your body’s ability to fight fat and build muscle, but will inhibit the development of lifestyle-related diseases that can surface later in life. "When we’re in our 20s, we don’t really think about that because it doesn’t seem very real to us," Heller says. "But diseases like cancer and cardiovascular disease build up over time; they don’t just happen suddenly when you’re 50 or 60. If you’re eating poorly in your 20s, you’ll see the consequences of that in later years."
Many 20-something women neglect calcium, says Laura Corio, M.D., an OB/GYN and author of The Change Before the Change (Bantam, 2000). "Many [women in their 20s] aren’t drinking milk and are always watching their diets. If they’re not getting calcium they’re not building bone, and we build bone until about age 35," Dr. Corio says. Not stocking a calcium reservoir now will later put you at risk for osteoporosis, a disease that weakens bones, putting them at risk for fractures (particularly of the hip, spine and wrist). An estimated 34-million Americans, 80 percent of them unaware women, currently suffer from low bone mass, a precursor to osteoporosis. "Many cases of osteoporosis can be prevented, and if you don’t have solid bone-building years, you can’t get them back. They’re lost," Heller says.
Healthy future Rx
Keep bones strong by including non-fat dairy products like yogurt, skim milk, tofu and low- and non-fat cheese (skip the saturated fat and higher calorie versions), and leafy green vegetables like collard greens, kale and spinach in your daily nutrition mix. Consider taking a calcium supplement if you can’t tolerate dairy foods.
Improve your nutrition instantly by forming a whole-foods-only snacking habit. Buy pre-cut veggies, snack size packages of raisins and nuts, and tote self-sealing fruits like apples, bananas and oranges wherever you go. "When you work hard to maintain a healthy diet and you’re including all the vitamins, minerals, phytochemicals, antioxidants and minerals like calcium in your diet (non-fat diary and green leafy vegetables), you’re writing yourself the healthiest ticket you can for your future," Heller says.
Getting in the fitness groove now, even if fat loss is not a concern, is just as key as nutrition for a healthy life in future decades. "If you are inactive now, it’s harder to start having an active lifestyle later in life," Heller says. Experiment with different types of workouts and sports (solo, group activities, new classes at your gym, outdoor adventures) to find the most convenient and most motivating combination for you. Then, just do it—four to five days a week.
30s
What’s happening: Metabolism
Just like bones, muscles reach their full development this decade. "Your peak, in terms of muscle mass and function, is in your 30s," says Dr. Sreekumaran Nair, M.D., Ph.D., a metabolism specialist at the Mayo Clinic. Lean muscle tissue burns more calories just to exist than all other bodily tissue, so delaying its decline, which also begins this decade, is the key to keeping your metabolism going strong.
Potential health challenges
After it peaks, muscle mass declines about 5 percent per decade, says Dr. Nair. "The quality of the muscle also declines—not only the strength and endurance, but the metabolic function of the muscle." Less muscle equals a lower metabolism, so yours may hit a speed bump now if you don’t strength train and monitor your intake. "For good or for ill, everything you eat counts," Heller says. If weight begins to creep on now, she says, take a hard look at how much you’re really eating.
Childbearing and breastfeeding may further drain calcium stores. The RDA for calcium in non-lactating women is 1,000 milligrams to 1,200 milligrams if you are nursing. Consider taking a calcium supplement if your diet doesn’t hit these daily amounts.
Your 30s may bring long workweeks, kids and/or growing family responsibilities, and stress may begin to seriously impact your health as a result. "Life’s stresses may feel like they’re adding up about that time; your metabolism will reflect that," Heller says. Stress is one of the biggest triggers for overeating, and is also an independent risk factor for heart disease, she notes.
Another metabolic monkey wrench may be the onset of perimenopause (or pre-menopause), which can begin up to a decade before "the change." Though most women do not begin the warm-up to menopause’s reproductive shutdown until their 40s, symptoms of perimenopause—with its notorious "hot flashes"—can surface as early as 35.
Healthy future Rx
Keep muscle and bone mass up with a targeted fitness program that includes strength training, aerobic work and flexibility training. "Muscle quality decline can be substantially prevented by an exercise program," Dr. Nair says. "Rather than becoming weak and trying to regain strength, if people start in their 30s they can prevent this from happening in the first place," he says.
Although menopause is likely years, even decades off (the average age of menopause in American women is 51), the same fitness and nutrition vigilance can combat the symptoms of menopause before they begin. "When I talk to 30-year-olds around the country, they’re saying `Is this really going to happen to me?’ " Dr. Corio says. "I tell them they’re fortunate because if you start changing your diet and start exercising now, you’ll sail through this and not see the [weight] changes [before and during menopause]."
Start conquering stress by realizing what stressful situations you can’t control (like sitting in traffic). "If you really think about it, you can develop a habit of letting that go," she says. Develop your ability to cope by performing this simple "stress drainer" exercise once or twice daily: sit or lie in a comfortable position and close your eyes. Breathe rhythmically and take four to five minutes to relax every muscle in your body, one at a time, starting with your toes.
40s
What’s happening: Metabolism
As perimenopause may begin in your 40s, your metabolism will slow more noticeably if unaided by nutrition and exercise, and your weight may begin to shift. "The ability to synthesize muscle proteins declines by mid-40s almost 40 percent," Dr. Nair says.
Potential health challenges
Perimenopause may throw your body out of whack as it gets ready to close its reproductive chapter with menopause. Beyond hot flashes, perimenopause can cause changes in menstrual cycle (shortening or lengthening of periods, changes in menstrual flow), moodiness, migraines, insomnia and even dry skin.
Healthy future Rx
To lift metabolism and your mood, supplement your fitness routine by increasing your activity throughout the day. "Developing active habits rather than only exercising at a particular time is key," Dr. Nair says. "Do anything physically active that you can." Take the stairs instead of the elevator, park farther from buildings or walk the dog 10 minutes longer. It all adds up to an increased calorie burn over time, and releases a few extra endorphins, those "feel good" brain chemicals into your body. "I tell my 40-year-olds, `do everything you can so you can sail through this change and not have perimenopausal symptoms as well,’ " Dr. Corio says.
Now is the time to form a more active partnership with your physician. "It’s all about preventative medicine and early diagnosis," Dr. Corio says. She recommends women undergo a bone density test at 45 or the first sign of a hot flash, and not wait until 55 or 60. "By that time you could lose a substantial amount of bone, and it won’t be easy to catch up," she says. She also recommends yearly mammograms beginning at 40 and cholesterol and blood triglyceride screenings every five years.
50s
What’s happening: Metabolism
Menopause will likely make its biggest impact on metabolism in this decade, and digestive changes may also become a factor for women in their 50s. Lower levels of the female hormone estrogen slow the rate at which food leaves the stomach (gastric emptying), so you may not be able to polish off a meal at the same rate as your younger counterparts.
As you go through menopause, if you’re curious about hormone replacement therapy, consult your doctor to determine if it’s a viable option for your individual circumstance.
Potential health challenges
Menopausal and post-menopausal central adipose accumulation (fat gain around the middle), commonly referred to as an "apple" figure type, can lead to increased risk for heart disease, cancer and diabetes, Dr. Nair says. Digestive distention in the stomach itself can also become a problem due to slower gastric emptying.
Menopausal women need to be watchful for any symptoms of uterine cancer, the fourth most common cancer in women, Dr. Corio says. Although it typically affects postmenopausal women, 25 percent of cases affect those still menstruating. Like other forms of cancer (breast, ovarian and colon), uterine cancer begins when a woman’s estrogen levels are disproportional to progesterone levels. Report any and all changes in menstrual patterns to your doctor, and don’t assume they’re a natural part of perimenopause, Dr. Corio says. If you are postmenopausal and experience a period after not having one for a year or more, also see your doctor.
In addition to diabetes, heart disease and cancer risks skyrocket in your fifties. As metabolism slows, weight gain by itself can increase these risks.
Healthy future Rx
Preventative tests to continue in your 50s include a yearly mammogram, cholesterol and triglyceride blood test (every five years), bone density test (every one to two years), and a colonoscopy every five years beginning at 50 (35 if you have a family history of colon cancer), according to Dr. Corio.
Keep your digestive tract running smoothly by eating foods with a "rough" reputation like whole grains, nuts and seeds, Heller says. Eating smaller, more frequent meals and drinking at least eight glasses of water a day will also keep digestion on an even keel.
Fitness in your 50s should remain as important as it does in your 20s with an emphasis on strength training. If you haven’t tried strength training, it’s not too late. The American College of Sports Medicine recommends strength training for all people over 50, even into their 90s. A recent study published in the journal Medicine and Science in Sports and Exercise, nursing home residents between ages 87 and 96 increased their muscle strength almost 180 percent after eight weeks of weight lifting. Strength training not only helps build bone and fire metabolis, studies have shown it can stem symptoms of arthritis, relieve mild depression and aid sleep, not to mention fight off diabetes, heart disease and cancer by controlling weight.
Getting and staying healthy for today is a worthwhile effort for any woman. Add a little forethought about how to build a healthy tomorrow right now, and you’ll have the achievement of a (long) lifetime.
Nutrition through the ages
The way you eat, even as early as your 20s, can keep your metabolism revved, at ease or eliminate peri- and menopausal symptoms and protect you from age-related diseases, Dr. Corio says. "If you start changing your diet now, you won’t see the weight changes in your body and won’t feel sluggish [as you age]." Here are Dr. Corio’s top nutritional strategies for staying healthy through the decades:
- Focus on a substantial breakfast that always includes protein. "The beginning of the day is like the start of all your power," Dr. Corio says. "Women who skip breakfast are destined for a bad day." Protein for breakfast keeps you fuller than a high-carb meal such as cereal. Good sources include eggs, low-fat cheese, tuna, chicken and turkey.
- Cut down on carbohydrates and increase lean protein in your diet.
- Use poly- and monounsaturated fats (almonds, avocados, olive oil—snack on mixed nuts in moderation) and avoid saturated fat.
- Eat garlic (for its blood-pressure-lowering and cholesterol-reducing properties).
- Take a multivitamin (reduces the amount of the hormone homocysteine, an incompletely metabolized amino acid found in animal protein—the overabundance of which is an independent risk factor for heart disease).
- From whole foods get your vitamin B (reduces homocysteine), vitamin E (a powerful antioxidant that halts oxidative stress in the brain that may contribute to Alzheimer’s disease) and vitamin D, calcium and magnesium (a bone-strengthening trio).
How much you eat
Counting calories may be a daily drag, but if you’re fighting unexplained weight gain as you age, grab a pen and paper and give yourself an intake reality check. "Calories count in your life," Heller says. "People tend to need a little less food as they get older." Look how a few extra calories above what your body needs can add up over time:
Extras: One piece of fruit ; one cup of yogurt or two small cookies or one 16-ounce fruit beverage
Approximate calories per extra: 200
Frequency of extra consumption: Five days per week
Equals: 1,000 calories per week; 4,000 calories per month; and 40,000 calories more than your body needs in 10 months (almost 11.5 pounds).
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