Your Guide to Midlife Health and Wellness

Your Guide to Midlife Health and Wellness

This is a quick “Guide to Midlife” to help you gauge how well you’ve been managing your health and wellness. Are you being proactive, or leaving it to chance? Remember: get better, not older.

Your Guide to Midlife Health and Wellness


A guide to midlife?

Who needs that!

Well, pretty much all of us, assuming we’re fortunate enough to get there, given that the alternative is unseemly.

And so, I submit for your consideration a guide to midlife health and wellness, organized thus:

Let’s dig in…


Woeful Stats Tell the Tale

midlife stats

The reason we need a guide of sorts is that most of us don’t get to midlife and beyond in good health:

  • Almost half of all people aged 45-64, and 80% of those 65 and over, have multiple chronic conditions [1].
  • By 2030, the number of people aged 50 years and older with at least one chronic disease is estimated to increase by 99.5% from 71.522 million in 2020 to 142.66 million [2].
  • Nearly half (approximately 45%, or 133 million) of all Americans suffer from at least one chronic disease [3].
  • The CDC estimates that six in ten adults in the United States currently live with a chronic disease such as cancer, heart disease, or diabetes [4].

Let’s get more specific. Consider the chronic disease percentages for American adults:

Heart Disease:

  • 9.0% of adults aged 55-64 have been diagnosed with heart disease [5].
  • Overall, heart disease affects more than 79 million Americans and is responsible for 40% of all deaths [6].

Diabetes and Prediabetes:

  • 10% of the non-institutionalized population has diabetes [6].
  • As of 2018, approximately 34.2 million Americans (10.5% of the population) had diabetes, with 90-95% of cases being type 2 diabetes [7].

High Blood Pressure (Hypertension):

  • 26% of the non-institutionalized population has hypertension [6].

Obesity and Overweight:

  • 61.6% of the population is overweight or obese [6].


Between 9.9% (for adults aged 55 to 64) and 24.7% (for adults aged 75 and over) have cancer [8].


  • 20% of the non-institutionalized population has arthritis [6].
  • The number of people with arthritis is expected to increase to 67 million by 2030 [6].

Chronic Lung Diseases:

  • 19% of the non-institutionalized population has respiratory diseases [6].

These statistics highlight the significant prevalence of chronic diseases among adults in the USA, especially the middle-aged and older.

If all that wasn’t bad enough, it’s important to note that many of these conditions are interrelated, and individuals often have multiple chronic conditions simultaneously. According to the 2018 National Health Interview Survey data, 27.2% of US adults had two or more chronic conditions [9].

This is crazy, because most of these chronic diseases are lifestyle-generated, meaning that they’re preventable.

(Read how Medicine 2.0 fails us.)

What follows is not going to solve every midlife health issue you have or may get, but this short guide to midlife health and wellness will check some boxes.


Midlife: A Crucial Transition Period

Midlife can feel overwhelming due to the multitude of responsibilities it brings. Often referred to as the “sandwich generation,” those in midlife may find themselves caring for both aging parents and growing children, while also managing demanding careers.

Clearly, people in midlife can get burned out because they have too much to do, and too little time to do it.

The rest of this post is a rewrite and amplification of a recent NY Times article. If you have a NYT’s account, you can read it here, but I encourage you to stay with me, because I’ve added several additional suggestions to contribute to your guide for midlife health and wellness.


The years designated as “midlife” are getting stretched these days. You’d expect that midlife would be a number that represents half of the average lifespan of a human population, but who doesn’t know people who think of themselves as middle-aged at 60? (Good luck reaching 120!)

Not to diminish the value of optimism, “midlife”is generally defined as the ages between 40 to 60 (see how enduring that optimism is?), and  serves as a significant inflection point in our lives. It’s a phase where the cumulative effects of our past behaviors begin to manifest, and we start to notice changes in our bodies and minds that can be both frustrating and unsettling. That said, this period also presents an opportunity. Our future health and well-being aren’t predetermined, and there is ample time to make lifestyle adjustments that can positively impact our later years.

“Things that you do or things that happen in midlife can have long-term effects on the later life,” said Margie Lachman, a psychology professor at Brandeis University who specializes in middle age. “So it’s a really important period for paying attention to your body.” [9]

The NY Times asked readers for their most pressing questions about middle age. The paper received more than 800 responses ranging from the mundane to the existential. Although everyone’s experience of aging is unique, certain issues repeatedly surfaced. Here’s what experts had to say about these common concerns, their origins, and potential ways to address them. (Their quotes come from the Times.)


Aches, Pains and Weight Gain: The Midlife Predicament

If you don’t take preventative measures, what follows is what you can look forward to.

Aches and Pains

The sudden onset of aches and pains in midlife can be perplexing. Often, it’s simply muscle soreness resulting from decreased physical activity compared to younger years.

People tend to be less active in middle age than they were in young adulthood, explained Scott Trappe, a professor of human bioenergetics at Ball State University. Activities like raking the yard or shoveling snow can leave you achy if your muscles aren’t accustomed to the exertion.

A reduction in physical activity also leads to a decline in muscle mass as we get older, which can lead to painful joints. “What muscle does is it takes up some of the load that you’re carrying and frees the joints from the pain,”” noted Dr. Arun Karlamangla, a professor of medicine at UCLA. Our joints also stiffen with age due to wear and tear, resulting in scar tissue. “The tendons and muscles lose some of their plasticity,” added Dr. Trappe, increasing the risk of injuries during rapid or high-force movements.

Women face an additional risk as their bones weaken when estrogen levels drop during menopause. You don’t feel bone density loss until you break something, said Dr. Stephanie Faubion, director of the Mayo Clinic’s Center for Women’s Health.

What Can You Do?


Exercise is crucial for mitigating these issues, these aches, pains and muscle loss. Strength training helps offset declines in muscle mass and bone density, while aerobic exercise benefits cardiovascular health. “The silver bullet is physical activity,” Dr. Karlamangla emphasized. That is true not only for muscle and joint issues, but virtually any age-related changes.

(See my post, 4 Exercise Prerequisites for Longevity.)

Even a little exercise is beneficial, but aiming for moderate or vigorous intensity yields the greatest advantages. Consulting a personal trainer, physical therapist, or doctor can help tailor an exercise regimen to your needs. And if you need some encouragement to get started, peruse my posts about exercise.

Weight Gain: The Midlife Surprise

Midlife weight gain often feels sudden, but it usually results from the gradual accumulation of weight over many years. Contrary to popular belief, metabolism remains fairly stable from ages 20 to 60, according to a 2021 study published in Science, “Everybody kind of thought it would be declining through middle age, but it doesn’t at all,” said Herman Pontzer, a professor at Duke University.

However, subtle changes can affect body composition and metabolism. A decline in muscle mass alters physical appearance, while a shrinking brain volume (which accounts for significant energy use) can slightly reduce calorie burning. Women, in particular, may notice an increase in belly fat due to hormonal changes associated with menopause.

Managing Weight Gain

To manage weight, focus on eating a balanced, whole food diet that eliminates ultra processed foods and get regular physical activity. Addressing muscle loss through strength training and staying active can help maintain a healthy weight and body composition.

(See my post, How Ultraprocessed Foods Can Hurt Your Brain and Gut.)


Perimenopause, Libido and Hormones

Hormones and detoxification

They’re all connected.

Perimenopause: the Flash

Perimenopause is the transitional period leading up to menopause. It can begin as early as the mid-30s, and is characterized by fluctuating ovarian function and estrogen levels.

Symptoms like hot flashes, night sweats, irritability, brain fog, and mood changes can be challenging and stressful. Historically, these symptoms were often dismissed, but it’s now recognized that they can significantly impact a woman’s quality of life.

Libido: The Midlife Decline

Both men and women can experience a decline in sex drive during midlife. For men, lower testosterone levels, health issues like hypertension, and psychosocial factors can contribute to reduced libido. For women, hormonal changes during menopause can lead to decreased sex drive, often exacerbated by symptoms like hot flashes and vaginal dryness.

Men, if you want to boost your testosterone, check out my posts about how you might be able to do this naturally.

Women, check out: Do Women Really Need A Libido-boost From A Female Viagra?.

Hormonal Therapy and Management

Hormone therapy can usually alleviate symptoms, and its risks are lower when started early.

Hormonal birth control may also help regulate hormones during perimenopause. Consulting a healthcare provider can help determine the best approach. But in the meantime you might want to read, Women’s Hormone Replacement Therapy: What You Need to Know.

As I write in that post, “Women’s hormone replacement therapy, if done right, can substantially improve health outcomes. Unfortunately, one poorly conducted study in particular has dissuaded women from such therapy.”


Memory and Cognitive Changes

midlife cognition

Memory decline in midlife is often a normal part of aging. Brain volume peaks in our 20s and gradually decreases, affecting memory and cognitive speed. While everyone experiences these changes, their extent varies based on lifestyle factors like exercise, nutrition, and mental engagement.

Engaging in physical and mental activities, maintaining social connections, and ensuring adequate sleep and nutrition can support brain health and slow cognitive decline.

If you’d like to explore this topic further, read my post: 15 Nutrients that Protect the Brain from Dementia.


Health Screenings: Proactive Measures

Midlife is when the cumulative effects of behaviors and exposures start to manifest, increasing the risk for chronic disease. Regular screenings for conditions like cardiovascular disease, diabetes, and cancers can detect issues early, allowing for timely intervention.

Recommended Screenings

  • Blood pressure and cholesterol: Regular checks starting before middle age. Make sure your ApoB is tested! I was shocked to discover I was in the risk zone, despite having perfect HDL and LDL numbers. Read Why High ApoB Is A Ticket to Heart Disease.
  • Pre-diabetes: Testing at age 35 if overweight or obese, and at age 45 otherwise. You want to be below 100 mg/dL (≈ 5.6 mmol/L).
  • Mammograms: Starting at age 40 to screen for breast cancer.
  • Colonoscopies: Initial screening at age 45 to detect colon cancer.
  • Bone density scans: Recommended at age 65 for women, but consider earlier screening if there is a family history of osteoporosis.
  • Prostate cancer: Screening guidelines vary, so discuss with your doctor based on your risk factors.
  • Lung cancer: For current or former heavy smokers, screening is recommended starting at age 50.


Managing Midlife Stress

midlife stress

Despite the stress, midlife is also a time when people are often better equipped to handle their responsibilities. David Almeida, a professor at Pennsylvania State University, has found that as people age, they tend to become more adept at managing stress. “It’s a time of life where we’re more likely to be in charge,” he noted.

Emotional well-being tends to be relatively stable during midlife, though recent studies suggest that financial pressures and other modern stressors may be increasing stress levels.

One of my posts about how to relieve chronic stress will sure help. In the meantime, take a deep breath through your nose, hold it, slowly exhale and repeat. 🙂

Life Satisfaction and Reflection

Midlife is a period of reflection and reassessment. As people evaluate their lives and compare their achievements with their earlier aspirations, they might experience a dip in life satisfaction. Susan Charles, a professor at the University of California, Irvine, explained that this reflection can lead to a temporary decrease in happiness. However, as people age further, they often come to terms with their lives and feel more content.

In this regard, you have two choices that can help relieve your stress burden; either:

  1. Accept where you are in life, or
  2. Do something about it.

(I need to remember that myself!)

Finding Contentment

midlife contentment

Focusing on gratitude and appreciating what you have can improve overall life satisfaction.

There’s a science of gratitude. Or perhaps I should say that science has studied the matter and concludes that your life will be better if you practice gratitude. I tell you all about that in How To Practice the Science of Gratitude.

Engaging in fulfilling activities, nurturing relationships, and setting realistic goals can also contribute to a more positive outlook during midlife.


Your Takeaway on How to Navigate Midlife

Midlife is a pivotal period that presents both challenges and opportunities. Understanding the physical, emotional, and cognitive changes that occur during this time can help you make informed decisions to improve your health and well-being.

Do your best to stay active, maintain a healthy lifestyle, and proactively addressing health concerns, as I reviewed above.

Remember: midlife can be a fulfilling and productive phase of life, and it’s up to you to make it so.


Last Updated on June 29, 2024 by Joe Garma

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Joe Garma

I help people live with more vitality and strength. I'm a big believer in sustainability, and am a bit nutty about optimizing my diet, supplements, hormones and exercise. To get exclusive Updates, tips and be on your way to a stronger, more youthful body, join my weekly Newsletter. You can also find me on LinkedIn, Twitter and Instagram.

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