The 26 rules you need to know to stay fit and healthy over 40

Midlife fitness is not just about what you do, but how you do it. How can you be sure you’re doing it right? Here are the answers.

Fitness can be achieved at any age. Picture: Supplied

1. How much exercise should I do a week to keep my heart healthy?

As a minimum, the British Heart Foundation recommends being active every day and building up to a total of 150 minutes of moderate-intensity aerobic activity - fast walking, jogging, cycling, stair-climbing - each week. Starting with ten-minute sessions is a good way to build up. However, the more you can do, the better the outcome for your heart, with a recent study involving 90,000 people debunking the myth that too much exercise is harmful.

Over a five-year period researchers from Oxford University found that those in the top 25 per cent of people who did vigorous-intensity activity had, on average, a 54 to 63 per cent reduction in the risk of heart disease. “There is no limit to what you can do in terms of physical activity [to improve heart health],” says Rema Ramakrishnan, an epidemiologist who co-led the study in PLOS Medicine.

2. Can I lose weight by weight training alone?

The only way to lose weight is to eat less and move more. How you move doesn’t matter as much as how often you launch your body out of a chair. However, if you hate running and cycling - considered prime fat blasters - strength training is an option. It makes sense when you consider that muscle is a metabolically active tissue, burning calories and slightly elevating our metabolic rate.

In 2021 researchers from the University of New South Wales conducted a review of evidence involving 58 studies looking at the effect of strength training on fat blasting. They found that participants who did resistance training involving their own body weight or lifting weights for 45 to 60 minutes an average of 2.7 times a week lost an average 1.4 per cent of their total body fat - roughly a pound in fat mass for most participants - over five months, an amount the researchers say is similar to what we might lose through cardio activity. But it’s not clear-cut. Others have shown that after eight weeks only, a group doing aerobic exercise saw a significant drop in body weight (2.2lb) and fat mass (by 2lb), whereas the weights group showed a slight decrease in waist circumference. Even exercise scientists can’t agree on this one and your best bet is still to do a bit of both.

3. What weights should I start with when weight training?

There are no hard and fast rules for this one other than to find a weight (dumbbell or kettlebell) that you can comfortably lift for 12 to 15 repetitions of an exercise, with the last two reps posing more of a challenge. If you are female and a complete beginner this might be 2-3kg for dumbbells, although you might want to invest in a set of 2kg, 4kg, 6kg and 8kg dumbbells because you will quickly get stronger. For male beginners, starting with 4-6kg and investing in a set with 8kg and 10kg weights will see you through.

Older men and women can safely lift weights.

4. I have lower back pain. Can any exercise help?

The worst thing you can do for lower back pain is to stop exercising. Physiotherapists say that our backs are designed to move, to bend and to lift heavy loads and that weight training is good for them. It is when we spend too long sitting that our back muscles become deconditioned, making it more likely that we strain a muscle when we bend or reach for something.

Fiona Wilson, an associate professor of physiotherapy at Trinity College Dublin who has published many papers on back pain, says that in most cases there will be improvements in lower back pain once people start moving more. “There is still an embedded fear that certain types of exercise will make the pain worse,” Wilson says. “People should be running, lifting weights and doing any activity they can to prevent and improve back pain.” Walking is one of the best things you can do to relieve back pain, and reformer Pilates has a huge following among former sufferers who claim it has helped.

5. What is the best exercise to get rid of my midlife paunch?

Once you’ve addressed your diet - too much sugar, alcohol and processed foods are a no-no - you need to put in some hard graft, exercising for an hour at a moderate intensity on at least three days a week. Moderate intensity means you should be huffing and puffing. This amount of aerobic exercise enhances your muscles’ glycogen (sugar) uptake and triggers fat burning. From there, you can add HIIT (high-intensity interval training) and squats, burpees and lunges, which activate the largest muscles - the glutes, the quadriceps and the hamstrings - which ramps up your metabolic rate and works to prevent fat from being stored around the belly. Core exercises - planks, sit-ups, mountain climbers - can be added to the mix, but don’t expect them to work magic on their own.

6. What are the best exercises for flexibility? Does it have to be yoga?

Everyone thinks of yoga as the best route to better flexibility - and it definitely helps - but it’s not the only way to become more bendy. Stretching for five to ten minutes every day will bring improvements, but so will moving more in any way you can.

Declining flexibility is compounded by inactivity, and the more time we spend sitting down, the more likely we are to develop chronic tightness.

Beyond this, Pilates and t’ai chi and other martial arts are fantastic flexibility boosters and assisted, “deep” stretching that aims to provide myofascial release ("myo” referring to muscle and “fascia” being the connective tissue) can be helpful. While it sounds counterintuitive, lifting weights takes your body into different ranges, improving mobility and flexibility in the long-term.

7. I have achy knees. What’s the best exercise to do that won’t make them worse?

By middle age many people have knee niggles, whether they exercise regularly or not. It’s likely to be the result of wear and tear, and with damage to cartilage - the smooth, rubbery layer covering the ends of bone - can lead to osteoarthritis. Running is often blamed for causing knee pain, but in fact sports that involve a lot of twisting and landing of the knee joint - skiing, football, tennis - are more likely to cause problems. Even if you do have knee pain, you should keep moving, says Bill Ribbans, a professor of sports medicine at the University of Northampton and a consultant in orthopaedic surgery, and any form of exercise that doesn’t cause pain will promote joint health.

“Vary your activity as much as you can so that your knees get a break from load-bearing with activities like swimming,” Ribbans says. “It is so important to keep active, and a sedentary lifestyle is as bad for your joints as hammering them with too much of one sort of exercise.”

By middle age, many people are dealing with niggles.

8. What’s the best all-round exercise for the pelvic floor?

Your pelvic floor muscles are the sheet of muscle and connective tissue (fascia) that stretches from the pubic bone at the front to the tailbone at the back and which supports the bladder and bowel within the pelvis. Men and women have them, and like any muscles they adapt to exercise by becoming stronger. A review by Cochrane, a medical research database, suggested that regular pelvic floor exercises are the most effective treatment for incontinence. The Chartered Society of Physiotherapy recommends simple moves such as sustained contractions - squeezing and holding the pelvic floor muscles as if trying to stop yourself from passing urine or wind - for five to ten seconds several times every day. Learning to target and control your pelvic floor muscles is something that is taught in a good Pilates class, so it’s worthwhile joining one.

9. How do I get faster at running and cycling?

If you always run or cycle long and slow, you will get fitter but not faster. To improve your speed you need to pick up your pace in some sessions, and among the best ways to do it is with sprint interval sessions. Improvements can be swift.

A group of experienced recreational runners prone to plodding at one pace were asked to introduce four to seven bouts of 30-second sprints interspersed by four minutes of slow recovery jogging three times a week. After just two weeks they had significantly improved their 3,000m running time, according to results of a study in the Journal of Strength & Conditioning Research, and the same approach would work for cyclists. Adding intensity in other ways - hill training and weight training - will also help to increase your overall speed.

10. How far do I need to cycle a week to lose weight?

As with any exercise, it’s not easy to offset calorie overconsumption through cycling alone. Cycling at a moderate speed for an hour uses about 500 calories, which means three 60-minute bike rides a week would burn 1,500 calories, about the amount in a roast dinner and pudding. To lose weight you’ll need to gradually make your bike rides longer or faster and include more general activity every day, as well as reduce the amount of calories you consume.

11. Should I spend more on high-tech trainers as I get older?

Not necessarily. Good trainers will provide some cushioning and support for your feet, but the primary reason for buying them should be comfort, not cost. Expensive shoes often come with a host of performance-enhancing extras that are only really necessary for competitive athletes. Trainers have a longer shelf life than they used to but will need replacing when they no longer support your foot, when the tread has worn away, or when the cushioning starts to degrade. I am a fan of the Hoka One Speedgoat 4 for trails, Saucony’s Kinvara for roads, and the Brooks Hyperion Tempo for faster running, and I tend to switch between them. All are cushioned, supportive and super-comfortable.

The key to good running shoes is not necessarily spending more.

12. Should I try barefoot running shoes?

Barefoot running shoes with a glove-like fit for your feet were all the rage a few years ago, with proponents claiming that they simulated a more natural running style that helped to strengthen muscles in the feet and lower leg, which should result in fewer injuries. Ironically it transpired that, while minimalist running shoes can work for some people, barefoot runners tend to report more calf and Achilles tendon injuries, which is most likely to be a result of transitioning too quickly to barefoot workouts and overloading muscles and tendons in the process. If you want to use them you will need to develop strength and conditioning in the lower limbs, but the best place to go barefoot is probably around the house.

13. I am in my fifties - am I mad to take up football at this age?

Absolutely not, unless you have significant knee pain when you play. You may need to adjust expectation because you will not be playing with the same intensity as you did in your twenties and will need to factor in longer for recovery. Still, a review of studies looking at recreational five or seven-a-side football in middle-aged and older adults, published in BMJ Open Sport & Exercise Medicine, concluded that football should be considered “for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle” and that playing weekly for 3 to 12 months helped players to boost strength, cardiovascular fitness and reduce weight.

It would also help to make sure you are generally fit enough to play by building your strength and endurance off the pitch, with a fitness regimen that could include elements of running, cycling and weights.

14. Is it still possible to get a six-pack in midlife?

Yes, it’s possible - although it is also harder work. For men and women, middle age means a gradual decline in everyday activity coupled with hormonal changes that often lead to weight gain around the midriff. It’s this combination that results in your six-pack being concealed beneath a layer of fat. Before anything else, you need to blast surplus body fat with moderate to high-intensity cardio activity (running, cycling and swimming are good) and some resistance training, including weighted squats and lunges, which are terrific calorie burners. Only then will definition become apparent, with strength in the core enhanced by as wide a range of abdominal exercises as possible. Planks, push-ups, side planks, the Superman hold, the Hundred (a Pilates exercise) and leg raises are great, and as much variety as possible is key.

15. Can any form of exercise help with the menopause? And if so, which is best?

There’s no evidence that exercise will speed or slow the menopause, but plenty that it will help with symptoms and mental wellbeing.

In a 2020 study Amanda Daley, a professor of behavioural medicine at the University of Loughborough, found that women who were prescribed physical activity sessions for six months had experienced improvements in symptoms such as hot flushes and night sweats, as well as sleep patterns, physical health and psychological wellbeing. There is evidence that everything from yoga to weights and running are helpful, so it’s a matter of finding what works for you.

16. What is the best way to protect my bones as I age?

Consuming plenty of the bone-friendly nutrients such as calcium (from dairy, leafy greens and nuts), vitamin D (oily fish and supplements), magnesium (fruit, seeds and pulses) and phosphorus (chicken, wholegrains and pumpkin seeds) is important, but so is exercise. Bone is a living tissue that reacts to increases in loads and forces by growing stronger.

For exercise to increase bone strength it needs to involve either shifting your body weight off the ground with jumps, strides and jolts, as with skipping and running, or adding load, so that it adapts and strengthens, which you can achieve with weight training. Swimming and cycling aren’t great bone builders, so mix up your activities if these are what you do most often.

17. How do I avoid getting a stitch when I run?

Rule No 1 is not to overeat or drink too much before exercise. A side stitch is likely to be linked to irritation of the parietal peritoneum, the layers of membrane inside the abdominal cavity, and a full stomach exacerbates the friction.

Researchers at the Manchester Royal Infirmary confirmed that drinking large amounts of fluid immediately before running was associated with stitch in some runners. Fruit juice and cordial were the worst offenders because they empty more slowly from the stomach than water and sports drinks. Slowing down your breathing and breathing in a rhythmic pattern have been shown to relieve the pain.

Don’t forget to stretch.

18. Should I be doing exercises that focus on balance? And if so, what?

Our balance deteriorates significantly from middle age onwards and contributes heavily to falls in the home, which cost the NHS about pounds 450 million a year. A review by the Cochrane Bone, Joint and Muscle Trauma group confirmed that exercise plays a significant part in prevention of falls, and Medical Research Council-funded trials at MMU suggest that simply standing on one leg every day helps to maintain and improve balance. Try doing it for 20 seconds on each leg, then progress to doing it for longer with your eyes closed.

19. I want to take up running. I’m in my sixties. Am I too late?

You are never too old to take up running. In fact, exercise scientists at Manchester Metropolitan University (MMU) demonstrated this with a study in the journal Frontiers in Physiology in which they assessed a group of runners in their fifties to seventies. Some of the participants were lifelong competitive endurance runners, others had only started running after 50, yet by the age of about 70, physical fitness and muscle health were equally good in both groups.

“It is never too late to start regular, intense endurance running,” says Professor Jamie McPhee, the head of the department of sport and exercise sciences at MMU and the study author. If you are new to it, start by running and walking - a “couch to 5km” programme is a great way to get going - gradually building up until you can comfortably do 5km running.

20. How useful is a heart monitor when training?

Your heart rate is influenced by age and genetics, but also by physical fitness. The number of times your heart beats per minute when at rest varies substantially between individuals - for an average adult the NHS says that it should be 60-100bpm - but the fitter you are, generally the lower it will be as your heart becomes more efficient with each beat.

A heart-rate monitor provides a guide as to how hard you are exercising, with the aim being to spend at least some time each week pushing yourself vigorously enough to get your heart rate up to 70 to 85 per cent of your maximum. They are useful for beginners who have a tendency to push too hard early on in a workout, and some elite athletes use them to plot their training. They are not a necessity and are not foolproof - other factors, such as food, caffeine, stress and temperature, can cause your heart rate to change. But if you are data-inclined, they are worth a try.

21. Are there any supplements that I should take to improve my fitness?

Many supplements promise to provide performance-enhancing benefits, but few live up to the claims when put under rigorous scientific scrutiny. One that most exercise scientists do routinely recommend is vitamin D. It has been shown in trials to have a direct link with muscle power, velocity and jump height and to reduce muscle wastage in the elderly.

A review of evidence by Ribbans showed that vitamin D supplementation for all ages can improve bone density and reduce the risk of fractures as well as improve muscle strength. In winter the government recommends we all take 10mcg daily, but studies suggest that high-level athletes can safely tolerate 100mcg a day - most of us will be somewhere in between. Ribbans says that vitamin D2 is much less effective than D3 in reaching desired serum levels.

Good posture is important.

22. What’s the best way to improve my posture?

As we age, our levels of lean muscle mass drop, which can result in a more stooped posture. Weak core muscles force you to push out and brace the tummy to achieve tension in the floppy muscles, and muscle weakness in the buttocks, legs and back is often the cause of slouching.

All-over strength training is the best way to improve your posture, and something like a TRX suspension trainer that uses your own body weight as resistance is an excellent investment. If you spend a lot of time sitting at a desk, in a car or on the sofa, moving more and shifting position often is essential.

23. If I were to buy one bit of kit, what would you recommend?

My golden rule is to invest proportionately more money in the item of equipment that supports the body part you will be using most - if it’s running that will be trainers, if it’s cycling it will (obviously) be a bike. Any cash left over should be used to buy a watch that will support your goals. Garmin, Polar and Apple watches are great for tracking your miles, providing training programmes and prompting with fitness reminders.

24. Should I invest in a massage gun or foam roller?

These have become the go-to items for alleviating post-workout muscle soreness and are said to work partly by releasing the tightness of myofascia, the thin connective tissue that surrounds our muscles. Massage guns are easier to use, and a recent study suggested that two weeks of using one might help muscle healing and building. But they don’t come cheap, starting at about pounds 129. Foam rollers are cheaper - you can get one for about pounds 15 - but are trickier to use correctly. A review of 49 studies on foam rolling found that they can help to reduce muscle stiffness and pain as well as increase range of motion, but should be used in combination with general stretching.

If you exercise intensely, either (or both) would be worth the investment. If not, a gentle walk is all you need to aid recovery the day after a workout.

An ice swimmer in Berlin. Picture: Getty Images

25. Is cold-water swimming in winter good for you?

It’s reputed to have wide-ranging benefits, but most of the evidence is anecdotal. By all means try it if it makes you feel good, but don’t expect miracles and do take precautions because cold water can be dangerous. Studies at the University of Portsmouth’s extreme environments laboratory show that the cold shock of a wintry dip - the “gasp” and hyperventilation that typically occur in the first 90 seconds - can result in swallowing the small amounts of water necessary to initiate the drowning process, which is the most common cause of death when people dive into cold water. It takes about six cold-water immersions to acclimatise. The Portsmouth team advises that you always go in slowly so that breathing is steadied before you start to swim, and never stay in for longer than ten minutes. There are, of course, lots of reasons why a winter swim might be beneficial. A few small studies have shown that it prompts the release of stress hormones that prepare the immune system to deal with infection, and some researchers have shown that cold-water swimmers have fewer upper respiratory tract infections, such as colds. Most people just feel better for doing it - reason enough to take a dip.

26. How do I find a good sports bra?

Studies at the University of Portsmouth’s breast-health research group have shown that even an AA cup needs support during high-impact activity such as running, and that female breasts can move 21cm up, down and sideways during a workout without adequate support. The delicate Cooper’s ligaments that support the breasts can stretch by more than 2cm during even a short bout of running, all of which can result in long-term sagging.

A good sports bra is essential but hard to track down. When shopping around, look for thick, cushioned straps, a thick chest band and multiple hooks for maximum security and minimal jiggling about. After decades of trying and testing, the best I have come across are the Maaree Solidarity Sports Bra (pounds 64; maaree.com), featuring a unique curved panel of fabric that runs over the top of the breasts to reduce upward motion, and the Absorber Ultimate Run (pounds 46; shockabsorber.co.uk), which is scientifically proven to withstand the impact of high-intensity exercise.

The Times