Plus, how to tweak your routine to live a longer, healthier life
By Markham Heid
Most of us can skate through our first four decades of life without paying a significant health penalty for our vices — assuming those vices are modest and our genes are good. But after age 40, our bad behaviours start to catch up with us, especially when it comes to our cardiovascular health…
“A number of risk factors for heart disease really start to go up in [a person’s] 40s,” says Deepak Bhatt, MD, executive director of interventional cardiovascular programs at Brigham and Women’s Hospital Heart & Vascular Centre and a professor of medicine at Harvard Medical School. “The risk for high blood pressure, high cholesterol, obesity, diabetes” — pretty much all the major drivers of heart trouble — “all start to go up substantially.”
But there is a silver lining: If you’re still relatively young, it’s not too late to adopt heart-healthy ways, Dr. Bhatt says. And even if you’re already in your 40s, 50s, or 60s ditching some not-so-healthy habits can pay dividends down the road, he says. Here are six things you should make an effort to change now to ensure your heart stays healthy for decades to come.
Once you hit 40, you’re at risk for gradual weight gain — the kind that slowly but surely expands your waistline and puts you at higher risk for heart disease, Dr. Bhatt says. “Your metabolism is slowing, so if you’re doing what you’ve always done, you may start gaining weight,” he adds.
Heart Helper: Step on the scale every day. To keep future weight gain from catching you by surprise, get in the habit of stepping on the scale every day. Dr. Bhatt recommends checking your weight first thing in the morning without any clothing on before you’ve eaten or showered. “You want to get a consistent evaluation that allows you to compare how your weight is changing over time,” he says. While fluctuating a few pounds day to day is normal (diet, hydration, and hormones all influence your daily number), if the scale trends upward week after week, that’s a sign you may need to make some diet adjustments.
Your goal is to stay within 15 pounds (just under 7KG) of the weight you and a doctor have identified as your ideal target, adds Ted Epperly, MD, a physician, and president of Family Medicine Residency of Idaho.
Heart Hurter: Always going back for seconds
Evidence continues to pile up in support of a Mediterranean diet for optimal heart health. But whatever you decide to nibble on, keeping an eye on your portion sizes is vital and can help you ward off weight gain. “A diet lower in calories is a good idea,” Dr. Bhatt says. Again, after 40, your metabolism starts to slow, he says, so overeating could lead to gradual, significant weight gain—the kind that imperils your heart—even if it doesn’t seem to have much effect on your waistline now. Skipping second helpings and sticking to appropriate serving sizes are both effective ways to safeguard your heart and waistline, Dr. Bhatt says.
Heart Helper: Watch portion sizes. As a rule of thumb, a serving of protein should be the size of your fist (3 oz), a serving of grains should be the size of a tennis ball (half a cup), and a serving of veggies should be the size of a baseball (one cup). As for fats, consume no more than one teaspoon of butter, one tablespoon of olive oil, or two tablespoons of nut butter. If after finishing your meal and digesting for 10 minutes you’re still hungry, sure, go back for more. The trick here is to check in with your hunger cues and only continue eating when you genuinely need to. And to make sure you don’t overdo it, stick to lower calorie options like fruits and veggies.
Heart Hurter: Saying “no thanks” to plans
Sure, we all need a night off every once in a while. But if you’re RSVPing “no” to everything you’re invited to, that can have surprising effects on your ticker down the line. “Friends are critically important to heart health,” says Michael Miller, MD, a professor of cardiovascular medicine at the University of Maryland School of Medicine. “We know that social isolation, as we get older, really wreaks havoc on the heart.” One 2016 study in the journal Heart found loneliness and social isolation are as bad for you as smoking when it comes to your risk for coronary heart disease and stroke. In fact, a lack of social relationships raises a person’s risk for heart disease by 29%, according to the report. While experts are still teasing out the reason spending quality time with friends and family is so good for our tickers, the authors of the study say it may have to with curbing stress.
Heart Helper: Stay in touch. Make an effort to maintain your friendships, Dr. Miller advises. Dr. Stein agrees, and says men in particular need to be careful not to lose touch with friends—something that often happens when men near their 40s. “Life is better when you have people to share your existence with,” he says.
Heart Hurter: Going too hard at the gym (or avoiding it altogether)
“Ideally, you’re exercising 30 to 45 minutes a day, three to four times a week,” says Richard Stein, MD, a cardiologist, and professor of medicine at New York University’s Langone Health. That said, if your workout of choice is super-intense— think CrossFit, SoulCycle, or Barry’s Bootcamp — you can have too much of a good thing, Dr. Stein says. Some research suggests too much vigorous exercise may damage the heart, especially later in life. Heavy exercise can also worsen underlying heart issues, Dr. Miller says.
Heart Helper: Learn your own limits. “Recognise that you can’t just get up and run a marathon,” he says. “When you’re 20, you can do that, but after 40, you need a five- to 10-minute warmup and cool down.” He compares the aging human body to an older car that’s been sitting outside in the cold. “It could still be a very high-performance machine, but it needs time to warm up,” he adds. Taking time to walk, foam roll, or stretch before and after vigorous exercise is always a good idea.
Heart Hurter: Not taking time to decompress
There’s no escaping stress. “It’s just a part of life,” Dr. Bhatt says. “But how you react to stress can make a big difference.” Other heart experts agree. “Stress is bad, but not being able to do anything about it—to have no control to make it better or worse—is what’s harmful in the long-run,” Dr. Stein explains.
Heart Helper: Say ‘ommm’. Both Dr. Bhatt and Dr. Stein say meditation has proved helpful in combatting out-of-control stress. “With or without a spiritual component, meditation can help you react to stress in healthier ways,” Dr. Bhatt says. (Need help getting started? Try our beginner’s guide to meditation and mindfulness.)
Heart Hurter: Smoking
“The rule with smoking cessation is you have to keep trying,” Dr. Stein says. “I think the stats show the average person who has successfully quit tried seven to 10 times before it worked.” Smoking tobacco is undoubtedly one of the worst things you can do for your heart. But the younger you quit, the better your prognosis, he says.
Heart Helper: Just quit! Talk to your doctor about a winning strategy for you. Depending on your needs and your individual personality, that may mean behavioral therapy, nicotine replacement therapy, medication, or a combination of treatments.