By Jessica Snyder Sachs
1. Work
Out 5 Days a Week?
It's not your
imagination: Our bodies simply become higher maintenance after 40. Indulgences
of food or drink are quicker to take revenge. Muscles require more maintenance.
Screening tests become more important. So there's a lot to remember -- and yet
the wellness precautions keep coming, with new dos and don'ts every passing
year. Can anyone do it all?
Actually,
no. And if you try, say experts, you may end up throwing in the towel on some
of the essentials, as well as what's helpful but optional. So find out where you
can settle for good enough and still enjoy great health.
Rule 1: Work out 30 to 60 minutes a day, five days a week.
The Midlife Shortcut: Catch up
when you miss workouts.
To reduce
the risk of heart disease, cancer, and osteoporosis -- all big concerns for
women over 40 -- experts urge us to exercise at least 30 minutes a day, five
days a week (and for maximum health benefits, make that an hour rather than
half an hour). But daily workouts can be difficult to fit into a life crammed
with work and family responsibilities. Then there's the knee and joint pain
that many women experience after years of pounding their way through
"healthful" exercise.
Why
there's wiggle room: The
cumulative hours -- the total time you clock each week -- is what really counts.
In fact, the weekend warrior has gotten a bad rap, says exercise physiologist
Jane Roy, PhD, of the University of Alabama at Birmingham. If you're too busy
Monday through Friday, weekends are a great time for getting in two or more
hours of enjoyable exercise a day. You can catch up by spending a weekend
morning or afternoon playing tennis with girlfriends, taking back-to-back
aerobic and Pilates classes, or going for a long walk or run.
Then,
during the week, concentrate on interspersing sedentary activities such as
computer work with small but frequent movement breaks, Roy adds.
2. Get a
Pap Smear Yearly?
Rule 2: Get a Pap smear every year.
The Midlife Shortcut: Get tested
every two to three years.
Sexually
active women under 40 should be tested every year, but women over 40 can
stretch it out to once every two to three years once they've had three or more
normal results in a row, as long as they're in a long-term, mutually monogamous
relationship or are not sexually active, and they're still getting annual
pelvic exams.
Why
there's wiggle room: When a
woman is either not having sex or always has it with the same person (and that
person is not having it with anyone else), she's not being exposed to new
strains of the human papillomavirus, explains gynecologist Stacy Tessler
Lindau, MD, of the University of Chicago Medical Center.
The
majority of people who have ever been sexually active have been exposed to one
or more strains of HPV. Most women clear the symptoms of the virus within a few
months. But in a small minority, the infection causes cells to become
precancerous over the course of several years. These are the abnormalities that
show up on Pap tests.
What that
means is the risk of precancerous changes (and ultimately cervical cancer)
becomes very low once women pass through this latency period without being
exposed anew by having sex with someone different. Even if you don't have a new
partner, says Lindau, "You can be exposed to new sexual partners through
your own sexual partner." That's why your relationship has to be mutually
monogamous; if you're not sure it is, continue to be tested every year.
3. Eat 5
Servings of Veggies a Day?
Rule 3: Eat your veggies: five servings a day.
The Midlife Shortcut: Aim to
include veggies in most meals.
Five
servings a day add up to a heck of a lot of vegetables. Using USDA food guide
serving sizes, you'd need to swallow up to 17 cups of salad or solid veggies a
week to meet that goal -- that on top of the four daily servings of fruit
you're supposed to get.
Admittedly,
as the over-40 metabolism slows, substituting produce for higher-calorie foods
and snacks can help with weight control. But as our lives grow exponentially
busier, getting down all those veggies can become overwhelming.
"Five
servings a day remains an admirable goal," says registered dietitian
Christine Gerbstadt, MD, of the American Dietetic Association. And she argues
that meeting it can be a lot easier than you think. "Potatoes count,"
she notes. "Just don't make it french fries every day." You can also
add salsa, tomato sauce, or any kind of bean to the list.
But she's
also willing to compromise. "A decent daily plan is to include some
vegetables in most meals, then concentrate on rounding out the rest of your
diet by pumping up the fibrous whole grains and healthy fats."
Why
there's wiggle room: If you
look at the big nutrition picture and aim for moderate goals, success may
encourage you to surpass your quota. But if you don't hit the mark every single
day, Gerbstadt says, you can get by with a daily multivitamin -- that will
ensure you get the vitamins and minerals that are naturally abundant in fresh
vegetables.
4. Brush
After Every Meal?
Rule 4: Brush after every meal.
The Midlife Shortcut: Put down
the toothbrush and grab some gum.
Or a
toothpick. Or gum. Or a glass of water. It's not necessary to brush your teeth
after every meal if you do something else to remove the food debris.
Why
there's wiggle room: Brushing
when you get up and before you go to bed is just fine, according to Edmond
Hewlett, DDS, of the UCLA School of Dentistry. In fact, Hewlett says it's a bad
idea to brush right after consuming acidic foods or beverages such as wine,
orange juice, and most soft drinks. "The acidity slightly softens tooth
enamel," he explains. So habitually brushing right after eating these
foods can contribute to tooth sensitivity and cavities.
Chewing
sugarless gum has other benefits besides removing food residue. It also
increases saliva, which contains minerals that help replace the enamel lost to
acidic food and acid-producing mouth bacteria. That's particularly important
after age 40, when your natural saliva production starts to decrease. And if
the gum contains xylitol, you'll get an added bonus: This sugar substitute
inhibits the growth of cavity-causing tooth bacteria.
5. Sleep
for 8 Hours?
Rule 5: Eight hours of sleep every night -- no sleeping in.
The Midlife Shortcut: Sleep late
on weekends.
Yes, the
human body does need eight hours of sound sleep each night, says Joanne Getsy,
MD, of Drexel University College of Medicine, in Philadelphia. "It's a
fallacy that you need less sleep as you get older," she says. "You
don't need less; you simply get less." Anyone dealing with hot flashes and
sleep disturbances knows this too well. But whereas many experts insist that
"catch-up sleep" isn't as good as the real thing, Getsy says there's
room for deviating from your normal wakeup and going-to-bed times.
Why
there's wiggle room: "The
aim should be to pay back your sleep debt as soon as you can," Getsy says.
Specifically, she recommends scheduling twice-a-week catch-up nights.
"Pick one weeknight and one weekend night, and don't plan anything on
those evenings," she advises. "Let them be your nights to
recover." Daytime napping is okay too, she adds: "Just keep it under
an hour so it doesn't interfere with a solid night's sleep."
As for
sleep-bingeing on weekends, Getsy advises staying in bed as late as you like on
Saturday. Then on Sunday, split the difference between when you'd like to get
up and when you have to get up on Monday. That will help ease you back into
your weekday schedule.
Even
better news: Getsy says that when it comes to sleep debt, it's okay to pay back
less than you borrowed. Usually one full night's sleep is enough to make up for
a couple of shortchanged ones, she says. "If you feel better in the
morning, you've slept enough."
6. Lift
Weights 3 Times a Week?
Rule 6: Lift weights three times a week.
The Midlife Shortcut: Try for
one or two sessions a week.
On top of
encouraging us to meet aerobic exercise quotas, the health gurus tell us to get
to the gym and pump iron at least three days a week. Strength training is
especially important after menopause, at which point a woman's body tends to
lose both muscle mass and bone strength.
"When
you make the muscle grow, you strengthen the bone that's attached to it,"
explains Felicia Cosman, MD, of the National Osteoporosis Foundation. Aerobic
exercise such as jogging works only about 20 percent of muscle fibers, she
says, while strength training with weights engages up to 90 percent.
Why
there's wiggle room: There's no
magic number as to how often you need to strength train. Aim for regularity,
Cosman says, even if it's just twice a week. Nor do you have to schlep to a
gym. "Weight machines and free weights are good," Cosman says,
"but so are equipment-free Pilates and yoga moves, and push-ups."
7. Do a
Breast Self-Exam?
Rule 7: Do a breast self-exam every month.
The Midlife Shortcut: Do it
often enough to notice changes.
We came of
age being trained to search for lumps every month. The mandate feels even more
compelling now, given how greatly the incidence of breast cancer increases
after 40.
As it
turns out, however, there's little evidence that obsessively examining yourself
really helps women catch more life-threatening lumps.
Why
there's wiggle room: After
years of urging women to perform monthly self-exams, the American Cancer
Society recently deemed them optional. But what's still important, says ACS
spokesperson Debbie Saslow, PhD, is that women become familiar with how their
breasts feel and what's normal for them. "For a lot of women, that's still
a monthly exam. For others, it's the occasional self-exam or simply paying
attention when getting dressed or showering."
Where Not
to Cheat
Here's
where our health gurus draw the line. Follow these three rules, they say, as
scrupulously as you can.
Keep
Moving
Yes, you get brownie points for working out on weekends, but you lose out on
lots of benefits if you just sit in a chair the rest of the week, says Jane
Roy, PhD, of the University of Alabama at Birmingham. So get up for a stretch
break at least once an hour at work (you could walk down the hall to talk to a
colleague instead of sending an e-mail), and a few times a day, catch some
fresh air with a quick five-minute stroll outside.
If you
need extra motivation, consider this: Five one-minute stretch breaks over the
course of a day burn just 15 to 20 calories. But over the course of a year,
that adds up to over two pounds of fat.
Get a
Mammogram Every Year
When cancer strikes women in their 40s, the tumors tend to be aggressive, which
means fast-growing -- so the early detection offered by mammograms is crucial,
says the American Cancer Society's Debbie Saslow. After menopause, women tend
to have slower-growing cancers, she adds, but the incidence increases. "So
going longer than a year just isn't worth the risk," she says.
Maintain a
Healthy Weight
Overweight women are more likely to develop heart disease, diabetes, and many
types of cancer than normal-weight women are.
In fact, a
recent analysis estimates that 20 percent of all cancer deaths in American
women are linked to excess weight. In general, cancer rates increase when a
woman's body mass index exceeds 25, says Colleen Doyle of the American Cancer
Society. The risk rises more dramatically when the BMI passes 30. Abdominal fat
appears to be closely associated with postmenopausal breast cancer and cancers
of the colon and pancreas. And some experts say that the risk increases when a
woman's waistline exceeds 32 inches.
Originally
published in MORE magazine, February 2009.
