generally have a higher risk for heart disease than women. Middle-aged men especially have a tendency to gain weight around the waistline (referred to as abdominal obesity), which increases their tendency to become resistant to their own insulin (or suffer from a condition called insulin resistance). Insulin resistance can impair your ability to handle blood sugar properly, increase your triglycerides, and lower your HDL (“good”) cholesterol. (Check out the section, “Recognizing the silent syndrome,” later in this chapter for more details about insulin resistance.) These conditions lead to a dramatically increased risk of heart disease. A sizable portion of all heart disease in men occurs in middle age. Exercise and even a moderate weight loss can dramatically improve the condition.
Heart disease is generally delayed in women by 10 to 15 years compared with men. Therefore, most heart disease in women occurs after the age of 65. Yet, at this later age, heart disease accounts for a third of all deaths in women. Three million women die from stroke each year. These deaths are more than the deaths from all types of cancer. Heart disease can occur in women younger than 65 if they’re heavy smokers, have high blood pressure, have insulin resistance, have diabetes, or if they have a family history of early heart disease. The good news is women can be proactive in their health education in preventive lifestyle choices such as diet and exercise.
Older adults
You fall into this age bracket if you’re a man older than 65 or a woman older than 75.
Most new heart disease events and most heart attack deaths occur in older adults. High blood cholesterol — especially high LDL (or “bad”) cholesterol — increases the risk for heart disease in older adults.
Your chances of developing high blood pressure increase with age. Information from the long-running Framingham Heart Study shows that a 55-year-old with normal blood pressure today has a 90 percent chance of developing high blood pressure in the next 25 years.
Looking at your body mass index
In the past, height and weight tables developed by insurance companies classified weights by frame size (small, medium, or large), with one table for men and one for women. BMI is now used as an assessment of body size. BMI looks at what people weigh and classifies their weight by degree of medical risk. The BMI is a close measurement of body fat in most people. The same table is used for men and women.
Figuring out your BMI
Go to www.nhibi.nih.gov/bmicalc.htm for an easy-to-use calculator to determine your BMI. Or, you can download one of the many BMI apps to your smartphone. Note: BMI is a screening tool and not necessarily a hard and fast rule. A person’s body type, muscle mass, and health status should be factored into determining a healthy weight.
GET MOVING: PHYSICAL ACTIVITY AND AGE
You never outgrow your need for physical activity. As you age, you need to be even more dedicated to being active. Normal aging results in a gradual decline in heart and lung function, nerve function, and muscle and bone strength. Being active improves your heart and lungs and allows you to do more work without feeling tired. Physically active older adults have faster reaction times, better balance, and better hand-eye coordination for performing manual tasks. Physical activity can reduce the number of fractures in older adults as well.
A BMI of 20 to 24.9 is considered a healthy weight. A BMI of 25 to 29.9 is considered overweight, but not obese. And a BMI of 30 or greater is obesity. Refer to Table 4-1 to determine your medical risk based on your BMI.
TABLE 4-1 Your Medical Risk Based on Your BMI
| BMI | Degree of Obesity | Degree of Medical Risk |
|---|---|---|
| 20 to 24.9 | None | None |
| 25 to 29.9 | Mild | Low |
| 30 to 34.9 | Moderate | Moderate |
| 35 to 40 | High | High |
| Greater than 40 | Severe | Severe |
Recognizing the limitations of the BMI
Because your BMI is based solely on weight and height, it may overestimate body fat in athletes and others who have a lot of muscle. If this applies to you, you’ll need a measure of your body-fat percentage. (Most gyms and fitness centers have facilities and trained personnel to complete these tests.)
On the other hand, BMI may underestimate body fat in older people or others who have lost muscle. So just remember to use the BMI as a helpful tool and realize that its readings and scores aren’t absolute.
Improving your BMI score
If your number is 30 or above, don’t make the mistake of thinking you have to reach the 20 to 25 range before you’ll see a benefit to your health. Research shows that if you reduce your weight by 10 percent or even lower your BMI number by 2 points, you’ll significantly improve many health factors such as blood glucose, triglycerides, cholesterol, and blood pressure. Give yourself six months to lose 10 percent of your body weight.
If you aren’t overweight or obese, but health problems run in your family, keeping your weight steady is important. If you have family members with weight-related health problems, you’re more likely to develop them yourself. Talk to your healthcare provider if you aren’t sure of your risk. Developing a regular habit of physical exercise and eating a healthy diet is the best way to prevent weight gain.
Identifying your diabetes risk
People who have diabetes have a blood glucose level (often called blood sugar level) that is too high. Everyone’s blood has some glucose in it because our bodies need it for energy. But too much glucose in the blood isn’t good for your health.
These sections discuss the three main types of diabetes.
Type 1 diabetes
Formerly called juvenile diabetes or insulin-dependent