It was the speed of it all that shook Linda Watkins†. The 48-year-old from Sussex was out walking her dogs with her mum one morning two years ago. A week later, her mum had a stroke – the double blood clot on her brain rendering her disabled on the left-hand side of her body. She went straight from hospital to an assisted living facility. She was only 68.
‘My mum never said “no”, did everything for everyone and had been spreading herself thin for years,’ says Linda, who works in PR. Daily duties had included being the primary carer to Linda’s stepdad, who has Parkinson’s disease, and she was the first to admit that chief among her coping tools was pouring herself a large drink. Consuming excessive amounts of alcohol is known to trigger atrial fibrillation – a type of irregular heartbeat that Linda’s mum was subsequently diagnosed with; it’s also linked with a raised risk of stroke.
‘It was a huge wake-up call,’ Linda reflects. ‘I wanted to be active and around for my two daughters, who are 10 and 12 years old. [Seeing what happened to my mum] made me realise I could end up going the same way if I didn’t do something about it.’ Alongside a hard-wired habit of reaching for a glass of wine when stressed was a pattern of people-pleasing that would see her work through her lunch hour instead of going for a run. Change didn’t come easily; it would be another 12 months before she found the courage to look at her habits head on. But two years on from that wake-up call, life looks a lot different.
Working with a functional nutritional therapist has empowered her to cook healthy meals from scratch, her alcohol intake is a fraction of what it was and weekends invariably feature gym sessions, bike rides and yoga. Now, instead of fearing her next decade, she’s embracing it. ‘I’ve got so much more that I want to do.’
Linda’s midlife health-over is a relatable one. Like the proverb about planting a tree, if the best time to overhaul your health was 20 years ago, the second best time is now. And just as you didn’t spend Friday nights in your twenties sowing the seeds of a sycamore, we suspect you weren’t tucked up in bed by 10pm, either.
The exact circumstances that led you to take a long, hard look at your health habits will be yours and yours alone. For some, like Linda, it’s witnessing the deteriorating health of a loved one; for others, the body begins to object to the things you’re inflicting on it – first quietly, then loudly. But a question lingers on the lips of anyone who’s ever counted their reps, tracked their daily two litres or weighed their protein. Beyond building muscle and smashing your parkrun PB, is it possible to undo the damage of a life not-so-well lived?
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Inherited well-th
The annoying answer? It depends. Lorna Harries is a professor of molecular genetics at the University of Exeter. She tells WH that the body’s ability to reverse damage is determined by both the impact and extent of the unhealthy habits, along with the age at which you overhaul them. But your genetic make-up plays a role, too; roughly a third of how an individual experiences ageing is genetically determined, says Professor Harries. ‘And you don’t get any choice in your parents.’
Another big factor in determining health outcomes is just as close to home. That residents of affluent areas can expect to live about 13 years longer than those in deprived ones illustrates just how intrinsic environment is to informing both how long you live (your lifespan) and how you’ll live in those years (your healthspan), says Professor Harries. Consider, too, that location is tied to socioeconomic status – itself a determining factor in your ability to eat well, exercise and make other solid choices for your health – and you begin to realise why the poorest in society have the odds stacked against them from birth.
But if some of your health outcomes are out of your hands, others are well within your grasp. Take that cigarette perched between your fingers on the odd night out. While smoking triples the likelihood of dying from cancer compared with never smoking, quitting – even at an older age – greatly reverses the risk.
A 2021 study* found that smokers who quit between the ages of 35 and 44 dodged about 90% of the extra risk of dying from cancer they would have shouldered had they continued to smoke – a statistic that puts them nearly on par with peers who’d never taken a puff. Even smokers who only quit after a cancer diagnosis have been shown to respond better to treatment and even lower their fatality risk from some cancers by 40%*.
Non-smokers, too, have some bounce back. Professor Harries points to the liver; as the body’s filtration system – processing not just nutrients but alcohol, medicine and other toxins – it routinely takes a battering. ‘If you’re not kind to it, you might get into a state in your fifties and sixties where it starts to complain,’ she says. ‘But if you take that seriously and amend your diet and the amount of alcohol you drink – all the things we know we should be doing – your liver can actually regenerate.’ Indeed, improved functioning can be seen in as little as three to four weeks.
In this sense, the liver is unusual; not all our organs have this capacity for regeneration. And yet, most organs have stem cells that are capable of repairing a significant amount of damage, adds Professor Harries, with the caveat that the cells themselves need to be functioning optimally in order to do this. She gives the example of those diagnosed with type 2 diabetes in their sixties and seventies; despite receiving the diagnosis later in life, by making some changes to their lifestyle, they may be able to ‘significantly’ improve their blood sugar control.
Hit job
If all this sounds like a green light to do what you want and call it a problem for ‘future you’, hold that thought. The age at which you overhaul your health matters – because of the amount of time you’re doing the thing, but also because your body’s ability to recover isn’t something you can bank on. ‘The key thing is how bad things were before you [made the change],’ adds Professor Harries – and that baseline is more than just a sum of your good habits minus your bad ones. As for the question of how well you can expect to age, it’s more complex than a dusty bottle of barolo – with the how and why of disease development still largely an unknown quantity.
While we know that obesity, for example, is linked with an increased risk of breast, endometrial, colon and 10 other types of cancers, scientists still don’t understand the mechanisms at play, limiting the process of prevention – until now. A team of researchers recently began studying how obesity can cause cancer – and whether losing weight removes the raised risk. ‘The question is: does the body remember it’s been obese?’ says Nils Halberg of the QIMR Berghofer Medical Research Institute. His research builds on the so-called ‘multiple-hit hypothesis’; this posits that cancer-causing gene mutations (present from birth or acquired, such as from disease) only progress to tumours in response to subsequent ‘hits’ to the system, causing further mutation.
This could explain why cancer rates are rising, with modern environments and lifestyles exposing us to more ‘hits’ than in the past, says Dr Halberg. ‘What we have shown is that obesity itself can act as a hit; if you have just one mutation, that doesn’t cause cancer, but if you add obesity on top, it’s enough.’ The question of whether the elevated cancer risk from obesity can be reversed is particularly pertinent in the age of GLP-1s, notes Dr Halberg, and could even lead to the development of other drugs capable of erasing ‘epigenetic memory’ – or how the body processes and remembers changes to its cells over time. With findings not expected until mid-2028, for now, the research highlights the ambiguousness of ‘good’ health and ‘bad’. ‘Sometimes people talk about it as an “on” and “off” switch, which I think is wrong,’ adds Dr Halberg. Such binary thinking underplays the complex interplay going on within the body.’
It also underplays the hormonal havoc wrought by a woman’s reproductive lifecycle, which explains female vulnerabilities to certain conditions. Take osteoporosis – a progressive disease characterised by low bone mass, leaving bones more vulnerable to fractures and breaks, which women over 50 are more at risk of. ‘It’s all to do with oestrogen – which plays a huge role in keeping bones strong and healthy throughout a woman’s fertile life – and also lifestyle habits,’ says Nikki Ramskill, GP and founder of The Female Health Doctor. Think: a lack of weight-bearing exercise, nutrient deficiencies or long-term medication, such as steroids. In an ideal world, says Dr Ramskill, you’d be laying the groundwork well before midlife hormonal changes. ‘What we’re trying to do is create a bank of really strong bones when we’re young, so that when we’re older – and go through menopause – bones can remain as strong as possible and hopefully avoid osteoporosis down the line.’
Gear change
But if the body has an ability to weather stormy conditions – both hormonal and lifestyle – there comes a point when doing so becomes more difficult, if not impossible. A study* last year found that, rather than ageing by increments, we experience changes in two dramatic bursts around the ages of 44 and 60. This aligns with Professor Harries’ findings on the genetics of ageing: ‘You tick along quite nicely until you’re about 50, but after that, chronic diseases become more and more common,’ she says. Indeed, their common roots mean that, after your first diagnosis, a second can be quick to follow.
A better goal than seeking to reverse change is taking steps to delay that inflection point for as long as possible. It’s this goal that researchers are articulating when they talk about ‘healthspan’: the proportion of your total life that you spend in reasonably good health. In the not-too-distant future, healthspan could be extendable with drugs. As the founder and chief scientific officer of Senisca (a spin-off company from the University of Exeter), Professor Harries is at the cutting edge of developing biotechnology to tackle cellular ageing, one of the common causes of chronic disease. Time, stress and DNA damage combine to cause more cells to become ‘senescent’ – and with it, less effective, even damaging. The drugs Professor Harries is working on are showing strong potential ‘to not just be able to slow, but reverse’ those features of cell ageing. ‘What we have shown is that you can take these really old, creaky cells and reprogramme them into younger cells – and actually restore functionality.’
In the future, Professor Harries suggests, such drugs could revolutionise ageing in much the same way that GLP-1s have transformed weight loss. For now, Senisca is focusing its efforts on treating certain diseases (specifically idiopathic pulmonary fibrosis). But some of the health-extending benefits of Professor Harries’ miracle drugs are already available – through following a bog-standard healthy diet. The drugs’ rejuvenating effects mirror those of compounds present in dark chocolate, blueberries and strawberries, as well as other natural foods. ‘If you’re eating a Mediterranean diet and lots of brightly coloured fruit and veg, you’re going to be maintaining this pathway that we work on anyway,’ says Professor Harries.
All of which underscores the importance of taking small steps to protect your health as early in life as possible. ‘Ageing is inevitable; ageing badly is not,’ adds Professor Harries, who singles out preserving muscle mass and protecting the immune system as two high priority interventions. The usual advice applies: quit smoking if you smoke, curb alcohol if you drink and consume a healthy diet that includes plenty of protein, as well as the minerals calcium and magnesium, adds Dr Ramskill. Don’t forget the importance of habitual exercise, too. ‘Make sure there’s a load going through the body that will put “stress” on the bones,’ insists Dr Ramskill. Think: lifting weights, dancing and walking, rather than cycling or swimming.
Systemic change
In the end, the goal isn’t to ‘unharm’ your health, but to delay the point at which time starts working against you. Though all the experts we spoke to when researching this piece were unequivocal about the link between age and disease, they were also crystal clear that it’s very much within our power to extend our healthy years, no matter how laissez-faire you were in the past. That could mean undertaking a clinical intervention, such as taking statins (meds to lower cholesterol), or it could just mean introducing sustainable lifestyle changes. ‘But the important message to get across here is: it’s never too late to change,’ adds Professor Harries. She cites examples of those she sees on cancer wards sneaking out for a cigarette. ‘People might think, “Oh, well, I’ve done the damage already; there’s really no point” – but even a small change will have a benefit to your whole system.’
Now that’s she’s overhauled her own health, Linda is intent on passing her health habits on to her daughters, to give them the head start she didn’t have. She’s also convinced her new approach to nutrition and fitness is helping the menopause symptoms – including brain fog and hot flushes – that she’s simultaneously been grappling with. ‘I really lost my mojo for a while,’ she shares. ‘But now I’ve got so much energy I feel like I’m in my twenties.’
5 things you can do for your health, starting now
1/ Start lifting
‘Women naturally begin to lose muscle mass and strength as they get older – particularly accelerating around menopause,’ says Oliver Rabie, a London-based NHS and private GP. ‘Strength training helps preserve muscle, improves metabolic health and maintains physical function, as well as being especially valuable for bone health and warding off osteoporosis.’ Try to do at least two sessions – lifting weights, using resistance bands or enlisting body weight – per week.
2/ Increase calcium
‘Foods rich in the mineral include full fat Greek yoghurt, cottage cheese and oily fish such as sardines, mackerel and salmon,’ explains Robyn Cohen, a GP at HCA Healthcare UK, of the nutrient that’s vital for everything from bones and muscles to the heart and nerves. She recommends seeking a blood test to check that you don’t have any specific deficiencies that need addressing, too.
3/ Prioritise sleep
‘It plays a huge role in physical and mental health, affecting mood, concentration, appetite and energy levels – but it’s often one of the first things to suffer when life becomes busy or stressful,’ notes Dr Rabie. ‘For many women, sleep can also be affected by hormonal changes, particularly during midlife.’ His advice? ‘Create a regular wind-down routine in the 30 to 60 minutes before you go to bed. ‘That might include dimming lights, putting work away, listening to music, reading, stretching or another relaxing activity.’
4/ Eat more fibre
Fibre has powerful health benefits, including reducing the risk of bowel cancer, heart disease and type 2 diabetes,’ shares Lucy Hooper, a private GP and co-founder of Coyne Medical in London, of why you should aim for 30g a day. ‘If your current intake is low, increase it gradually by 5g to 10g per day and drink plenty of water to minimise bloating.’ Seeds, beans, lentils, fruit and nuts can be added to salads, yoghurt, or alongside dishes such as salmon or chicken.
5/ Reduce substances
‘Particularly smoking, vaping and excess alcohol,’ advises Dr Rabie. ‘Smoking remains one of the most damaging things for long-term health, while vaping is not risk-free and people end up doing it more frequently.’ As for alcohol, drinking too much, over time, can affect multiple systems in the body, including the liver, brain and cardiovascular system, and is linked to an increased risk of several cancers.’ Struggling to cut down? Ask your GP to advise on services, such as the NHS Stop Smoking Service or Smart Recovery.
Lauren is a lifestyle journalist with digital and magazine experience. Find her covering all aspects of wellness - from fitness, nutrition and mental health, to beauty and travel. Morning HIIT, a lunchtime oat latte and evenings ensconced in a hyaluronic acid-infused sheet mask are her own personal feel-good pillars.
