How can middle-aged men live a healthier life? Photo / 123rf
How can middle-aged men live a healthier life? Photo / 123rf
From lying on the sofa to neglecting loved ones, is it time to rethink our behaviour? Dr Xand van Tulleken shares his expertise on how to avoid — or reverse — the midlife health slump.
“I was in good shape in my 20s, running around with lots of energy and relatively little responsibility. I had time to exercise and go to the gym. I didn’t have children, so holidays were active with friends my age,” he reminisces. “Then in my 30s the levels of responsibility went up massively, the pressures of life and children got in the way. My diet fell to bits, I was eating unhealthy food and gaining weight. That made me more sedentary, I didn’t feel good, and I didn’t feel like exercising.”
Xand, 45, hit his fitness nadir when he tipped the scales at 120kg, up from a healthy 82kg in his 20s. Previously, when filming the series The Secret Life of Twins with his fitter identical twin brother and frequent co-presenter Dr Chris van Tulleken, he had been described as a “disgrace to genes” by twin expert and Zoe fitness app founder Professor Tim Spector.
Dr Chris van Tulleken and his twin brother Dr Xand van Tulleken. Photo / BBC
Today, men are often sold the myth that decline is inevitable because as we age our testosterone levels reduce, or our metabolism slows, or our muscles naturally wither away, and so we can’t help but get podgy. This is tosh.
Dr Adam Collins, associate professor of nutrition at the University of Surrey, has some good news.
“The theory of a natural decline is not a satisfactory explanation for why suddenly what you were eating a decade ago that caused you no problems when you were young, now causes you to gain weight,” he says.
“Often at that time of life [early middle age] other things change. People get into relationships, they get married, maybe they have children or get a more stable job. Lifestyles change and these are often a big contributor, maybe because you are not going to the gym as often or maybe you are drinking more consistently. Maybe people can afford more-luxurious food and more of it. These are all big contributors, rather than this idea of unavoidable metabolic decline.
“Almost everyone who finds they gain weight, loses muscle and becomes less active in middle age does so because of lifestyle factors such as work pressure, less time, having children, becoming more sedentary. You eat less well, and you do less exercise.”
The good news, as Xand discovered, is that decline is reversible. In 2021, after meeting his wife, Dolly Theis, he got his life back on track.
“I fell in love and realised that I did have an incentive to live a bit longer,” he says. Today he’s a healthy 82kg. Conversely, his formerly fit twin brother, a busy dad of two with a third on the way, is now the unhealthy overweight one, suffering a midlife slump.
This switch forms the backdrop of the twins’ latest BBC Radio 4 series, A Thorough Examination with Drs Chris and Xand, in which the brothers explore the science of exercise and the dangers of inactivity, and in which Xand tries to encourage his brother to start living a healthier lifestyle.
Bad diet and fitness levels aren’t the only problems middle-aged men face. They often find themselves without friends and support networks, which is detrimental to mental health and can have deadly consequences as middle age is when men are most likely to die by suicide. Meanwhile relationships become more challenging as illustrated by the fact that 45 is the average age of divorce for men.
So which bad habits should men break to avoid the midlife health slump?
A sedentary lifestyle can increase the risk of mortality, cardiovascular diseases and more. Photo / 123rf
1. Stop lazing on the sofa
It’s very easy to sit at a desk all day, or to flop on the sofa and switch on the TV, or to drive five minutes up the road to the shops. Inactivity is often an easier choice than activity. The World Health Organisation (WHO) estimates 2 million deaths a year are attributed to physical inactivity and warns a sedentary lifestyle could be among the 10 leading causes of death and disability in the world.
Sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety. According to WHO, 60-85 per cent of people in the world from developed and developing countries lead sedentary lifestyles, making it one of the more serious yet insufficiently addressed public health problems of our time.
The way to break this cycle, explains Xand, is to start by setting small achievable goals that help activity become a pattern of behaviour.
“Establish a pattern, even if it’s one press-up a day, or running slowly for five minutes a day,” he recommends. “The aim is to make that absolutely regular. What you get from that is the confidence that comes from knowing you are someone who can set a goal and achieve it. It changes your psychological mindset and from there you can increase activity and set higher incremental goals.”
And don’t focus solely on equating activity with exercise.
“When we talk about exercise, we talk about the gym, which is great for some people, but being active doesn’t have to mean gym sessions. It can be joining a choir or birdwatching or golf, whatever gets you out and moving your body.”
2. Stop thinking a dad bod is inevitable and lift some weights
According to a University of Essex study in 2022, 69 per cent of men said they achieved the guidelines. However, only 28 per cent met the NHS strengthening guidelines in England (that is, undertaking muscle-strengthening activities on at least two days a week) — a figure that dropped to 16 per cent doing strength exercises with proven health benefits. And strength training becomes much more important as men age.
“One of the reasons that not exercising is bad for you as you get older is that you get less able to protect yourself from things like falls,” explains Xand. “Training muscles is not just about getting them stronger; it’s about improving balance and co-ordination and strengthening tendons and ligaments.”
“Buy some weights and have them hanging around the house,” he says. “It doesn’t have to be structured. I have some weights in the house and a chin-up bar. I leave the weights out around the house somewhere visible and lift them when I pass them. I spread it out throughout the day. Quite often I lift them if I’m chatting on the phone. I’m not Arnold Schwarzenegger, I’m not pumping iron, but I’m getting my strength training in.”
The same ad hoc process can be applied to leg-strengthening exercises such as squats and lunges.
The commonly held belief that drinking moderate amounts of red wine can be beneficial to health is false, a new study has found. Photo / 123rf
3. Stop hitting the booze every day
Middle-aged men can often fool themselves into believing that their drinking habits become healthier as they age, because they binge less and drink more premium alcohol, particularly red wine. Researchers at University College London found the number of units consumed by men reached a peak about age 25 and that from the mid-20s, alcohol consumption began to drop before plateauing between the ages of 45 and 60.
However, drinking daily or almost daily became more prevalent in middle age, and men started experiencing more health problems related to cumulative drinking. Meanwhile, a new study found the commonly held belief that drinking moderate amounts of red wine can be beneficial to health is false.
4. Stop ignoring food labels
Sedentary, wealthy, middle-aged men are a marketer’s dream, says Xand.
He explains: “In middle age booze and poor-quality food is constantly marketed to you because even gourmet food can be bad for you. When you are sitting in front of the TV eating with a glass of wine or a beer, you are an incredibly profitable human for someone. Whereas when you are going for a walk, you are not profitable for anyone. We live in an environment where the marketing is predatory and where it is hard to be healthy.”
Often the food we are sold as a luxury choice is bad for us, with the damaging ingredients and the sky-high fat, salt and sugar contents hiding in the label.
More than half the calories consumed by the average person in the UK come from UPFs, which are created through industrial processes and contain chemicals, colourings, sweeteners and preservatives that are not present in home-made food. UPFs have been linked to early death and ill health. The best way to identify them is to read labels. UPFs tend to have long lists of ingredients, many of which are unrecognisable, and have high fat, sugar and salt content. They also tend to have a long shelf life.
According to a study published in the British Medical Journal, cognitive decline can start about age 45 and “adverse cognitive outcomes” like dementia result from long-term processes over at least 20 to 30 years. Both men and women who were between 45 and 49 at the start of the study experienced a 3.6 per cent decline in mental ability over the decade.
However, various research also shows active lifestyles, both mentally and physically, slow down brain ageing. After education and employment training ends, many middle-aged men experience years, if not decades, of reduced or non-existent learning opportunities. Instead, the lure of the television, streaming services and box sets proves irresistible.
Behavioural psychologist and founder of workplace learning consultancy Laughology Stephanie Davies says: “The brain is like a muscle; the more you use it, the healthier it becomes, and it is particularly important to keep mentally active in middle age, to fend off later-life mental decline. You can continue to learn and build new neural pathways throughout life. In order to function well, brains need to refresh, rest and recover. Doing mentally stimulating tasks such as learning something new, doing puzzles, online courses, playing board games like chess or Scrabble, or even some video gaming, rather than passively watching the television, have all been shown to benefit cognitive performance.”
Middle-aged men find maintaining relationships hard. Photo / 123rf
Davies recommends: “It doesn’t have to be about the big romantic gestures. In fact, the small things are the most important. Future-proofing your relationship is more about building in small intimacies that become habits, such as making sure that you go to bed at the same time more often than not and saying good night to each other. Try and eat together. Hold hands when you are out walking. A lot of couples find they are at home together now that working from home is more common. It’s important to have boundaries to your workdays and for men to have interests of their own and a social network of their own.”
7. Stop staying in and not seeing friends
Research by the Movember Foundation in 2018 found 27 per cent of men said they had no close friends and that friendships become less strong as men get older, with 22 per cent of men aged 55 and over saying they never see their friends. This systematic emotional shutdown is bad news because male friendships are critical for overall health and happiness. Developing and maintaining male friendships can help lower stress and strengthen emotional intelligence. Indeed, one study found satisfaction in our close relationships can extend our mortality rate by up to 22 per cent.
Men’s friendships traditionally tend to revolve around activities such as watching sports, cycling, going to the pub or playing golf. One of the primary reasons men tend to shed friends in their 30s is because they do less.
“It’s the distractions that stop you doing things as you get older,” explains Simon Gunning, CEO of anti-suicide and mental health charity Campaign Against Living Miserably (Calm). “We lose connection with the world around us and the people around us. We settle for average or below-average TV boxsets rather than going out.”
His advice is simple.
The key to having a better life is taking initiative and control over your actions. Photo / 123rf
“Do that thing,” he says. “Just go out and do it.” As an example, he explains that every two months he and a friend take turns to book two tickets for something. It could be a show, a play, a gig, an event.
“It doesn’t matter if it’s no good, what matters is that we are doing something and having an experience, and not just putting the kids to bed and then watching TV which will create no memories and no awe, because we tend to lose that sense of awe in the world as we get older.”
Simon continues: “Social connections are a muscle you need to work because it gets weak quickly if you don’t. The key issues we try to help at Calm is a sense of self-worth, and going to the thing gives you that because you’ve got up and achieved something and created a sense of belonging to something bigger than yourself, you’ve had a collective experience. Even if it’s playing squash or dominoes.”
