What you do now could be the difference between thriving or struggling later. Photo / 123RF
Our party lifestyles take their toll between the ages of 36 to 46, shaping our health in coming decades. Here’s how to undo the damage.
For many of us, our 20s are a decade of hedonism – of giving barely a passing thought to our health. It’s the era where we chain smoke, binge drink and shun exercise.
But new research shows that by their mid-30s, this kind of party lifestyle will take its toll. Researchers in Finland found there were relatively few consequences to heavy drinking and smoking in people’s 20s, but those who continued these habits found their health begin to deteriorate at 36. Over the course of their lifetime, they were found to result in a plethora of health problems including higher rates of depression, cancer, heart disease, lung disease and early death.
In fact, the decade from 36 to 46 is a pivotal one for our future wellbeing. “What you do in that window shapes the health you’ll experience in the decades to come,” says Dr Philip Borg, an NHS oncologist and founder of The Longevity Doctor, a clinic specialising in preventative medicine.
It’s in our mid to late-30s that we stop “getting away” with unhealthy behaviour, as the cumulative effects of our lifestyle begin to show their impact.
“Chronic diseases are caused by long-term, silent processes like inflammation, triggered by habits including poor diet, stress, drinking, smoking and lack of exercise, which can slowly damage your cells, arteries and brain, starting decades before symptoms appear,” says Dr Borg.
Prior to this age, much of the damage can be undone – for instance, people who quit smoking by the age of 35 were shown in a 2022 study of half a million Americans to have a similar long-term mortality risk to people who have never smoked.
But the rates of lung cancer caused by smoking begin to rise steadily in the 40-44 age range, steadily for women and more rapidly for men, according to Cancer Research UK.
“In my clinic, I frequently see patients who wish they’d stopped habits like smoking earlier,” says Dr James Wilson, a consultant clinical oncologist at UCLH. “Age 36-46 is when we start to see patients developing conditions such as cancer, which could have been avoided with lifestyle changes.”
This is because the damage to within our cells builds up increasingly quickly from this age onwards. “Senescent cells are ones which have stopped dividing but are still active, and create an inflammatory environment which damages neighbouring cells,” explains Dr Borg. “The more unhealthy your lifestyle, the more of these cells you accumulate.”
Alcohol consumption is linked to seven types of cancer, including breast and bowel, with 17,000 cases of cancer attributed to alcohol every year in the UK. Again, its impact increases past the age of 35, as our ability to metabolise it decreases and the damage it causes to the liver accumulates, putting us at increased risk of liver disease, heart disease, high blood pressure, stroke, Type 2 diabetes and dementia.
“Once you’ve exposed your body to excessive drinking during this decade, you can’t reverse the risk,” says Dr Wilson.
The decade from 36 to 46 is a time in which women in particular, but also men, go through vast hormonal changes, which play a major role in our health.
For women, oestrogen and progesterone begins to decline as menopause approaches. “This affects everything, from a decrease in muscle mass and bone density, to lower immunity and our ability to process sugar and fats,” says Dr Harpal Bains, a longevity specialist and the medical director at Harpal Clinic. It also increases women’s risk of diseases including osteoporosis, heart disease, diabetes, depression, obesity and dementia.
Men’s testosterone levels peak in their early 30s and begin to drop after that. A recent study from Stanford University revealed a similar spike in age-related issues among men in their 40s, including weaker bones and poorer metabolic health.
“This is also a decade in which people are usually very busy in their careers, and many have young children, so they’re under a lot of stress,” says Dr Bains. “Stress hormones suppress oestrogen and testosterone even further, which puts the body under huge pressure.”
That’s why, she says, maintaining unhealthy habits such as drinking to excess, smoking, not exercising and eating poorly, have an even more profound impact during this period. “It’s absolutely vital to change your habits during this decade,” she says.
The positive news is that although the damage starts to mount up quickly from 36 onwards, it’s the ideal age to make changes which will reap rewards later.
“The decade from 36 to 46 is when our metabolic forgiveness begins to wane, but we still have tremendous capacity to course-correct,” says Dr Wilson. “Every positive change you make during this window contributes to your future health and potential longevity.”
As a start, it’s vital to cut alcohol consumption to NHS recommended levels: 14 units or less per week. And if you’re still smoking, quit immediately. “The evidence is clear: tobacco use accounts for about 30% of all cancer-related deaths,” says Wilson. “When I see people who continue smoking into their 40s, I think it’s madness.”
Although it’s best to stop smoking before 36, one US study suggested those who stopped between the ages of 36 and 44 could potentially add up to nine years to their life, while for those who did so between 44 and 54, it was potentially up to six years.
Fitness is next on the agenda. “Exercise is more important than ever at this age, because strength and VO2 max – the measure of your aerobic fitness levels – are the best predictors of future health and what activities you will be able to do later on in life,” explains Borg.
Aim to hit the minimum target of 150 minutes of moderate intensity exercise per week, as well as regular resistance training to maintain cardiovascular fitness, build bone density and prevent muscle atrophy. And remember: it’s never too late to start.
“Ensuring your diet is as good as possible is essential to support your body during this decade,” says Bains.
Ideally, minimise sugar, refined white carbohydrates and ultra-processed foods where possible, eat plenty of lean protein – particularly plant-based, from nuts, beans and pulses – and look after the microbiome by opting for a rainbow of fruit and vegetables and fermented foods such as kimchi and kefir.
“This will help your body through the hormonal turbulence going on, and also lay the groundwork for your future health,” notes Dr Bains. She recommends taking supplements including vitamin C, vitamin D and a vitamin B complex. She also suggests adding omega-3 fatty acids, which have been linked to everything from cognitive function to inflammation reduction and even longevity, and magnesium, which plays many roles, including in reducing cardiovascular disease and anxiety and improving sleep.
Prioritising sleep is also crucial, as not getting enough can increase the risk of cognitive decline later in life, as well as increasing levels of stress and depression and impacting hormone levels.
Borg suggests using breathing exercises regularly to improve your stress response, and says: “Spending time doing things you enjoy with other people is so important. Keeping stress levels in check and sticking to simple sleep hygiene rules can have amazing health benefits in the long term.”
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