The best gift you can give yourself at 40

Prevention is better than cure, right? Active! asks the experts to list the health concerns that could crop up in your 40s, so that you can gift yourself the best fortieth birthday present: health

The best gift you can give yourself at 40

They say life begins at 40. So do chest pains, arthritis and heart attacks. The good news is that if you are careful now, you might just be able to nip those health concerns in the bud. Experts list the seven problems most likely to hit when you hit 40 and what you can do now to avoid them.

1. Diabetes
The International Diabetes Federation has declared India the diabetes capital of the world, and estimates that the number of diabetic patients in India more than doubled from 19 million in 1995 to 40.9 million in 2007. It is projected to increase to 69.9 million by 2025. What's the real shocker though, is that since we all know at least one friend or relative living with the disease, we assume that it is one that can't be avoided.

Dr Vishal Chopra, Diabetologist, Dr LH Hiranandani Hospital, says that lifestyle is one of the biggest reasons for diabetes. "A sedentary lifestyle gives rise to many diseases, including diabetes. Up to the age of 35, a person has youth hormones, so their bodies are active. However, once they turn 40, things change. If you don't exercise, but continue to eat the same amount of food, fat is deposited in the body, which leads to hypertension and other blood diseases. Lack of sleep and vitamin deficiency will also make you prone to diabetes. Be especially careful if diabetes runs in the family."

What to do: Swear off junk food, eat more fruits and veggies
"An active lifestyle and dietary precautions are the only way out of this," says Dr Chopra. "Don't lead the McDonald's-and-remote-control lifestyle, eat every two hours, eat more greens and consume less oil. Avoid fruit juices, pickle, papad and confectionaries,"
he advises..

2. Coronary diseases
Heart diseases have replaced communicable diseases as the ultimate killer in India. A study done in 2010 concluded that about 25 per cent of deaths in the age group of 25 to 69 years occur, because of heart disease. In urban areas, the figure is as high as 32.8 per cent. Experts predict that unless there's a drastic change in current lifestyles and increased awareness, these figures will continue to rise.

"We normally see heart diseases in men over the age of 60, but in recent times, it's been reduced to 40 years," says cardiologist Amit Sharma. "Heart diseases are more prevalent in India than in the Western world. One of the major reasons is our gene pool and the food we eat. When aping the West, we eat junk, fatty food without realising that our metabolism isn't as high as theirs, so we tend to store the bad fat which gives rise to problems."

Dr Sharma has also noticed a rise of heart problems in Young India. "BPO workers tend to have lots of problems thanks to the irregular hours of work, a sedentary lifestyle, bad eating habits, smoking, drinking and late-night shifts," he says.

What to do: Practice following a healthy lifestyle
"Awareness is key," says Dr Sharma. "It doesn't matter if you're 30 or 40. You may feel great, but you must go for regular check-ups for heart disease. Eat healthy, sleep well. Exercise right, and don't go overboard with weights or cardio. We all know how to keep the heart healthy, but it's time to put our knowledge into action," he says.

3. Prostate cancer
Prostate cancer is a bigger menace in the West than in India, but that doesn't mean it isn't a threat. It is the leading cause of cancer in men: a man has a 17% lifetime risk of being diagnosed with prostate cancer, but a 3% risk of dying from it. While Asians fall in the low-risk category, studies indicate that if there is a history of breast cancer among the women in your family, your chances of getting prostate cancer also increase.

"Prostate cancer is usually found in men over the age of 50," says uro-oncologist Dr Rishikesh Pandya. It is typically a slow-growing cancer, remaining localised at first, and later spreading to nearby tissues and organs via the bloodstream and the lymphatic system.

"Many ignore the early signs (of prostate cancer) like urinary problems, urinating more frequently at nights, increased urgency, as signs of ageing, which delays diagnosis. Even those men who have never had urinary related diseases are at equal risk," says Dr Pandya.

What to do: Go for regular prostate exams
"The first two stages of prostate cancer are curable, provided it's detected, as there are no symptoms. One should go in for regular prostate examinations or take the PSA test. Make sure your doctor doesn't ignore the PSA levels. The third and fourth stage of prostate cancer is incurable. Awareness is the only way out," says Dr Pandya.

4. Mid-life crisis
Studies have indicated that mid-life crisis is more prevalent in the rat race of western countries than in cultures such as ours. It is typically categorised as a period of intense self-doubt on entering "middle age". Chronic depression, feelings of failure, worthlessness and general disinterest are common symptoms.

"Middle age sees a drop in hormonal levels and the onset of andropause, which alters a man's moods," explains psychologist Janki Mehta. "In a typical scenario, the spouse is going through menopause, which may affect the husband. Men may start pondering over their achievements, question their job and lives, and feel the need for a change to pursue what they really want to. Losing a parent or teenagers who'd rather be with their friends than at home can also add to the depression," she says.

What to do: count your blessings (or Pray)
"In India, middle age brings stability of life and career. Most people are well settled and start enjoying their life after struggle, even if it means just going to the movies or holidaying abroad," says Janki. "If there's a bout of self-questioning, it will soon be overcome because of the social structure and support we have in terms of family and friends. Indians believe in fate and destiny, which is good, because people might blame their fate and say God put us through the struggle to test us and we have to be strong. The important thing is to not give up."

5. Erectile dysfunction
Andrologist Dr Dilip Raja says, "Impotence is one of the most common sexual problems that affect half of all men over the age of 40, some time or the other in their lives. Impotence is not a disease, but a secondary condition brought on by other, primary causes. As men get older, they need greater sexual simulation to have a good, sustained erection. Occasional episodes of erectile dysfunction are common. It doesn't mean that there will be persistent problems in the future."

"There is a drop in testosterone after the age of 40," explains Dr Raja, adding, "Loss of libido and high blood pressure are some of the changes that take place in the ageing male. Erectile dysfunction can either be psychogenic or organic. While the psychogenic kind is seen in several young men, the organic one arises because of problems that include narrow arteries, sluggish blood flow, urinary infections, diabetes and surgeries. About 85% of impotence problems are due to physical causes, including disease, injury, or side-effects from drugs. Medicines for anti-anxiety and anti-hypertension can also cause erecticle dysfunction."

What to do: stay active (between the sheets and outside)
"Just like in other cases, practice makes perfect. Have regular sex and lead an active life. Exercise," advises Dr Raja. "The best way to avoid impotence is to stay in love all the time," he concludes.

6. Degenerative arthritis
Arthritis affects 15% of the population i.e. over 180 million people in India, making it higher than diseases such as diabetes, AIDS and cancer. Arthritis is surprisingly easier to prevent and cure than popularly believed.

"The age of people suffering from arthritis has steadily decreased from 55 years to 40," says Dr Sanjeev Jain, orthopaedic surgeon. "Most cases can be avoided if people paid more attention to their bodies. When we injure ourselves when younger -- either in accidents or daily life -- we tend to ignore the pain and get back to work.

While one can get away with this when young, one has to pay a price when older."

He adds, "I've noticed that those who work in BPOs and from the IT sector, those who ride bikes often on the pothole-ridden roads of Mumbai, people who jog frequently and those who work out without proper medical guidance are most at risk for arthritis."

What to do: Maintain a healthy weight, avoid alcohol
"Knees are load-bearing joints, so the first thing to do is maintain a healthy weight. If you've hurt your knee or any joint, get it checked immediately and then go easy on your body, even when the pain is gone. Avoid sitting on the floor or squatting for long. Avoid alcohol as that can give rise to arthritis. Keep ignoring your body and you might need a hip or knee replacement," warns Dr Jain.

7. Alzheimer's disease
According to the WHO (World Health Organization), around 18 million people worldwide suffer from Alzheimer's disease. This figure is excepted to double by 2025. Currently, more than 50% of those with Alzheimer's live in developing countries, and by 2025, this will be over 70%. The risk of Alzheimer's increase with age, with odds increasing to almost 50% for those aged 60 and over.

Neurologist Pawan Ojha says that while there are no specific risk factors that cause Alzheimer's, those who share a family history are more at risk than others. "Early symptoms of Alzheimer's include forgetfulness, especially short-term memory. People may forget their way home, or even inside their homes. Many forget their skills, like women who forget how to cook. In some cases, one might even hallucinate. The risk keeps increasing by 10% every year, so it must be caught early."

What to do: Keep the mind busy, learn a new language, cultivate a new hobby "Solving crosswords, quizzes and puzzles will not only make you smarter, but also healthier," says Dr Ojha. "If your family medical history has Alzheimer's, then get yourself screened regularly for early detection."

How De Niro beat cancer and Akram lives with diabetes

Robert De Niro: Prostate cancer survivor
Actor Robert De Niro would have not been alive today if not for his dedication to good health. The actor found out he had prostate cancer in October 2003 during a routine examination. While fans and the industry were worried about De Niro's illness, doctors were sure that he would be cured. According to People magazine, his representative, Stan Rosenfield, reportedly said, "Doctors say the condition was detected at an early stage because of regular check-ups. Because of the early detection and his excellent physical condition, doctors project a full recovery." The actor currently is living life to the fullest, cancer-free, and is an inspiration to others to fighting prostate cancer.

Wasim Akram: Poster boy for diabetes

The poster boy of diabetes awareness, Wasim Akram has given hope to many. Akram, who was diagnosed with diabetes when he was 30, says, "I don't think being a diabetic is a hindrance to leading a normal life. Tapping your blood sugar and maintaining a healthy lifestyle is the best way to cope with it." He has since busted several myths associated with the condition, including that diabetics can't participate in strenuous activity. Try telling that to the first bowler in international cricket to take more than 400 wickets in both forms of the game.