Want to Age Well? A Physician Answers Common Questions on Aging

It’s never too early (or too late) to start thinking about healthy aging. Even if you didn’t learn healthy living and aging habits when you were young, now is the perfect moment to take charge and be on your way toward a healthier life. Dr. S. Christopher Shadid, a family medicine physician at INTEGRIS, answers your most pressing questions about aging.

1. What’s the most important piece of advice you would give men and women in their late 40s to help them start aging healthfully?

In general, men and women have very similar issues to consider in order to age healthfully in their late 40s. First, and most importantly, is lifestyle. A combination of diet and exercise is the key to staying healthy. Try to maintain a regular diet that is low in fat, low in sugar, with moderate carbs.  It really is essential: you must put the appropriate fuel in the tank if you expect the ideal outcome of the machine.

Along those same lines, our bodies have proven that old adage of “if you don’t use it, you lose it." Exercise is very important in staying fit and active as we age.

Secondly, routine preventive health screenings are a must. This is where we start seeing some different recommendations by gender. (See question 2 for more info). Men and women should both start colon cancer screenings at the age of 50, unless they have a first degree relative with colon cancer; in that case, screenings should start earlier. 

Both men and women should also have yearly screening labs to monitor blood cell levels, cholesterol levels, kidney function, liver function and more. The main preventive advice for men in their 40s is to start taking a baby aspirin each day starting at the age of 45 (but this is only if there are no contraindications, so please talk to your doctor before starting). Women, on the other hand, have a few more preventive requirements, which include Pap smears starting at age 21 and mammograms which typically start at age 40.

2. What kind of preventive care do you need after age 50?

Men and Women:

• Yearly screening blood work
• Shingles vaccine at age 60
• Pneumonia vaccine starting at age 65 (unless you are at a high risk, and then you should start earlier, so make sure to talk to your doctor)
• Yearly flu vaccine

Men:

• Baby aspirin starting at age 45
• PSA test to screen for prostate cancer starting at 40 (although this is controversial)
• Colonoscopy starting at age 50
• Abdominal aortic aneurysm ultrasound screening between the ages of 65-75 if he was ever a smoker

Women:

• A Pap smear every five years from the ages of 30 to 65 (unless there other risk factors, which means more frequent Pap smears, so talk to your gynecologist)
• Yearly pelvic exams
• Mammograms starting at age 40
• Colonoscopy starting at age 50
• Baby aspirin starting at age 55
• Bone mineral density testing starting at the age of 65 (or sooner if you are high risk, so again, talk to your doctor)

3. How much alcohol can someone over 50 safely drink, and does our tolerance change with aging?

According to the CDC, “moderate” alcohol consumption is defined as having one drink per day for women and two drinks per day for men. “Heavy” drinking is defined as consuming 15 drinks or more per week for men and eight or more for women. Those are good standards to follow, although our tolerance does change with age, mainly because our bodies change as we age (size, body fat percentage, etc.), which means alcohol is metabolized differently.

4. I am a 45-year-old healthy woman. My grandmother died of complications from colon cancer when she was in her 70s. When do I start getting screened?

In general, colon cancer screening should start at age 50 for everyone unless you have a first degree relative with colon cancer (mom, dad, sibling). If that is the case, then you should have your first colonoscopy 10 years prior to the age in which your first degree relative was diagnosed. For instance, if your father had colon cancer at age 45, then you should start screening colonoscopies at age 35. If you are still concerned though, talk now to your primary doctor who knows your family history.

5. My friends are raving about the benefits of taking collagen orally for hair and nail growth and reducing facial lines. I am a 49-year-old female. Do you believe there are benefits in taking it? Is there any harm in taking this?

Collagen is a protein made in the body that acts as the building blocks for skin, bones and nails. We do lose collagen as we age, which can lead to wrinkling. Unfortunately, there are few studies that show oral collagen is beneficial in rebuilding these proteins. I would say that a healthy diet is more important, which will give you the vitamins necessary to help maintain collagen.

6. I read a lot about inflammation and the benefits of taking supplements like omega-3, turmeric and ginger, and Co-enzyme Q10 to help combat inflammation. Do you think these supplements do any good? Do you think inflammation is bad as you age, and what do you recommend to combat it?

Inflammation is real. It can affect every part of the body as we age, but most commonly our joints. I do think that vitamin supplementation can help, but it is by no means the "end-all-be-all."  

As I talked about in question 1, what is MUCH more important is what fuel you are putting in your body and how active you are. 

Inflammation is (in large part) a result of poor diet and a sedentary lifestyle. Having an appropriate diet and exercising is THE most important aspect of fighting inflammation and its formation. (For a healthy anti-inflammation diet, check out this one by Dr. Andrew Weil).

7. Is long distance running beneficial for someone in their 40s, or might it actually age you more? I train and run in marathons about every other year. I’ve heard that it’s more detrimental than beneficial to your overall health as you age. What do you think?

As in everything, moderation is key. I think running is a very good thing as part of a healthy, active lifestyle. Running is a great way to aid in cardiovascular health and to keep you moving. As I mentioned above, regular physical activity is so important to health.

Saying that, it IS somewhat traumatic to your joints to take a “blow” every time your foot hits the pavement because some studies show that it can lead to early osteoarthritis, especially when the exercise is long and intense. Again, this is why I say everything in moderation.

In my personal opinion, the best form of exercise, particularly as we age, is aquatic exercise. Swimming has the same cardiovascular benefits but is much less traumatic on your joints.

8. Are Botox injections safe to get on a regular basis?

Yes, Botox injections are safe to have done regularly. I do them for my patients in my office. Botox is a toxin that we can inject into a muscle to relax it, which should help to get rid of aging wrinkle lines. It typically lasts about three months. I have many patients who get them once a season to help rid themselves of lines. Also, keep in mind that early use of Botox can be preventive in helping to stop wrinkle line formation before it starts. I also like injectable dermal fillers, which are typically administered in conjunction with Botox. These can help reduce wrinkles and add volume where collagen (see question 5) may have been lost.

9. How much exercise do people over age 50 really need?

The CDC recommends 2.5 hours (150 mins) of “moderate-intensity aerobic activity” (such as brisk walking), or 75 minutes of “vigorous-intensity aerobic activity” (such as jogging) every week, and muscle strength training activities two or more days a week. This can be done all at once or in 10-minute increments.

10. I’m a 54-year-old postmenopausal woman. I have all the symptoms of menopause, such as hot flashes. My main concern is I’ve gained weight, mainly in my stomach and upper back. I mostly eat healthy, but crave sweets. I can’t stop the cravings. I power walk 30 minutes a day four times a week, but I can’t get rid of belly fat. What can I do to fight the cravings? How do I get rid of my belly fat?

Cravings and weight gain can definitely be an issue after menopause. Without those premenopausal hormones to provide aid, it becomes much easier to put weight on and more difficult to shed it. These hormonal changes can actually have a domino effect and change other important hormone levels as well.

Obviously, a combination of diet and exercise is once again key. But sometimes we need additional assistance in the form of medication. There are many medications available to aid in postmenopausal symptoms. These include hormones, weight loss medications, and serotonin and norepinephrine reuptake inhibitors (SSRIs). I recommend speaking to your gynecologist for full details.

11. What are the signs and symptoms of a tumor on the pituitary gland? What are treatments?

Pituitary tumors can present in many different ways. Your pituitary gland sends off many hormones (such as FSH, LH, ACTH, TSH, Prolactin, Endorphins and GH) which, if abnormal, can give you various symptoms anywhere in your body.

Most typically, pituitary tumors present with symptoms in the head due to a mass effect. Symptoms may include headaches, dizziness, and abnormal sense of smell or blurry vision (particularly peripheral vision). Many pituitary tumors are benign (non-cancerous) glandular tumors, because they don’t spread to other parts of the body, like cancers can do. Still, even benign pituitary tumors can cause significant health problems because of their location near the brain and because many of them secrete excess hormones.

Many pituitary tumors don't require treatment. Treatment for those that do depends on the type of tumor, its size and how far it has grown into your brain. Your age and overall health also are factors. Treatment involves a team of medical experts, possibly including a neurosurgeon, endocrine system specialist and a radiation oncologist. Doctors generally use surgery, radiation therapy and medications, either alone or in combination, to treat a pituitary tumor and return hormone production to normal levels.

S. Christopher Shadid, M.D., is a board certified family medicine physician. He graduated from the Ross University School of Medicine in New Jersey, and completed his residency at The University of Oklahoma Family Medicine Residency program. He can be reached at 405-715-5330.