Great Expectations: Fit at Forty

Midlife men and women begin to lose muscle mass as muscle tissue starts to weaken and shrink. On the plus side, however, the 40s can be the time when people are in the best shape of their lives. You can strengthen your muscle tissue by regular weight-bearing exercise and aerobic exercise. The 40s are a prime decade for getting in shape: the more you work out, the more your muscles (and the rest of your body) will support you.

In the 40s, bones also begin to thin. You can easily slow this by doing regular weight-bearing exercise, which strengthens the bones, and by eating a calcium-rich diet. You need 1500 mg of calcium a day. Foods such as sardines, canned salmon (with the bones), broccoli, tofu, beans, milk, and shrimp are some of the best sources. If you want to help ensure you're getting enough calcium, take calcium citrate supplements (it's easier on the stomach than calcium carbonate) and be sure you get ten minutes of sun exposure a day. The vitamin D in sunshine helps your body absorb calcium.

Getting your beauty sleep really works, and men and women alike need to establish regular bedtimes in the 40s, for this is when sleep patterns can become erratic. The best way to take charge of your sleep patterns is to get enough sleep each night or take brief naps during the day, says Jim Maas, Ph.D., a professor of psychology at Cornell University in Ithaca, New York, and author of Power Sleep (Villard Books, 1998). An internationally recognized authority on sleep health, Dr. Maas suggests that office workers lock their office doors at lunch and set their alarm clocks for a quick nap. "Ten- or fifteen-minute naps can give you needed bursts of energy," he says.

The truth is out: lackluster libido is caused not by headaches or stock market nose dives, but by falling testosterone levels--in men and in women. A simple blood test can determine individual testosterone levels. In men, low testosterone may affect sexual functioning, energy levels, mood, and other health factors. Perimenopausal women in their 40s with low testosterone levels may experience vaginal dryness, frequent bouts of low energy, and a lack of interest in sex; these symptoms may be greatly improved with the use of 2-percent testosterone cream, available by prescription from an ob/gyn. Men and women may both get libido back on track by using the new Androderm patch, a prescription remedy for low testosterone.

Bald jokes and unwanted comments about "bad hair days" are a reality for many in their 40s and 50s.

GRAYING At this time of life, hair begins to lose color and turn gray due to reduced numbers of melanocytes, the cells that govern skin and hair pigment.

BALDING Hair loss is determined by genetics--the baldness gene can be inherited by both men and women. To promote modest hair re-growth, try Rogaine, or topical minoxidil (a shampoo). Propecia, another option, contains a low dose of the prostate drug finasteride. Before using these drugs, ask your doctor about side effects. Note: midlife individuals with oily scalps may develop clogged hair follicles, which can lead to hair loss. Shampooing with powerful, nature-based formulae containing tea tree oil may help cleanse the scalp and improve hair growth.

THINNING HAIR The number of scalp hair follicles decreases as we age, and the rate of hair growth in still active follicles slows down. The quality of your diet, lifestyle, and shampoo regimen strongly influences hair's health. Certain vitamin and mineral deficiencies can cause thinning hair, which may be corrected by a balanced diet including fresh fruits, vegetables, and whole grains. You can also try "hair building" vitamin or herbal supplements from companies like Rene Furterer. Note: long-term use of corticosteroid drugs (such as prednisone) is known to contribute to thinning hair.

UNWANTED HAIR Hormonal fluctuations in midlife women often lead to sprouting hairs on the face. Men may find unwanted hairs, particularly in the ears, nose, and eyebrows--due to changes in hormone levels.

Exercise helps minimize aging and prolong life--it's that simple. If you're a couch potato, the good news is that starting a simple exercise regimen of walking 45 minutes every day will make you feel and function much better within a matter of days. (You may just look a little younger, too!)

The 40s are the ideal time to start exercising, in order to enjoy peak health during the prime of life. (Realize that the health-protecting benefits of physical activity continue as we age. When 40,000 postmenopausal women were studied over a seven-year period, those who did regular exercise were 20 percent less likely to die during that seven-year period than those who stayed sedentary.)

Aerobic exercises such as rapid walking, jogging, dancing, and hiking will help you lose weight and increase flexibility and endurance--but they will not increase strength significantly. For strength, you must do weight training, says Dharma Singh Khalsa, M.D., a Tucson-based physician who specializes in anti-aging medicine. "Studies show that after just three months of weight training," he says, "you can double the strength of your quadriceps, those large muscles in the front of your thigh that help you stand up and straighten the knee." Building strong quadriceps is essential for a strong gait and good balance, says Dr. Khalsa, and a strong gait can make you look and feel younger.

FYI: Studies have shown that even short-term weight training can help reduce depression in adults. Take it to heart, as depression increases exponentially with age in the general population.

Before you consider scheduling plastic surgery, realize that the above normal components of aging are often intensified by accumulated damage from smoking and excess exposure to the sun. There's a lot you can do to minimize these changes: don't smoke, avoid the sun, and drink eight to ten glasses of water a day. (Inner hydration helps flush out impurities from skin and other organs and body systems.)

Also be sure to apply SPF 20 skin cream on face, neck, arms, and hands every morning. (We're serious about the SPF 20 cream: skin can get sun damage even through the windows of your office, car or house!) Clinical trials have found that alpha- and beta-hydroxy acid skin care products may minimize wrinkling, surface roughness, and even some of the color changes caused by sun damage. Prescription skin creams containing vitamin A derivatives have also been found to reduce wrinkles and improve skin texture and appearance.

"Normal brain shrinkage is nothing to worry about," says Dharma Singh Khalsa, M.D., a Tucson, AZ.-based physician and author of Brain Longevity (Warner Books, 1999). "It happens to everyone, even royalty and Nobel Prize winners, but the good news is that you can practice several scientifically proven ways to improve memory and cognitive functions." These include:

• regular exercise, which reduces stress and promotes blood and oxygen flow to the brain.
• getting enough sleep each night.
• eating a low fat, balanced diet.
• taking daily supplements such as ginkgo biloba, which increases blood flow to the brain, and phosphatidyl serine, which has been found to optimize cognition in people who have no cognitive impairment.
• practicing meditation on a daily basis.
• taking daily vitamin E supplements, which have been proven to delay onset of Alzheimer's disease.

Starting in our 40s, tooth and gum health starts to weaken. Many men and women in their 40s begin to develop periodontal disease, the first stage of which is gingivitis, an inflammation caused by the build-up of dental plaque. (Take note: you can easily reduce plaque build-up by brushing and flossing after every meal plus getting your teeth cleaned every six months. Rinsing with mouthwash also helps minimize plaque.)

If gingivitis is untreated, periodontal disease develops. This is a chronic and painful inflammation of the gums and supporting structures of the teeth. Periodontal disease leads to gum recession, loose teeth, and changes in tooth position, which is why it is now the most common cause of tooth loss in people over the age of 40. Some people with periodontal disease occasionally must take antibiotics to control bacteria in the mouth.

Your 40s are the prime time to take positive dental action: get your teeth cleaned every six months, brush and floss after every meal, and be sure to clean and floss teeth thoroughly before going to bed.

Yes, they're a well-known drag, but digital rectal examinations are the first stop on the screening path for colon cancer. The good news is that they can literally save your life. This is because most colon cancers start as a polyp and have a pre-malignant stage of five to ten years. If polyps are detected during this pre-cancer period, you and your doctor can prevent subsequent cancer.

The big risk factor for colon cancer is our age: the annual incidence of colon cancer starts rising as soon as we reach midlife. This is why every woman over 40 should have a digital rectal exam during her annual pelvic examination and every man over 40 should have a digital rectal exam during his annual check-up.