Aging Gracefully: Tips from a Physician

In this episode, I’m drawing from over 20 years of experience—as a physician and a woman navigating this journey myself—to share real, actionable strategies for aging well, inside and out.

We’ll explore the core pillars of healthy aging, including the power of movement, nourishing your body with the right foods, getting quality sleep, staying socially connected, and being proactive with your healthcare. These are evidence-backed strategies inspired by the National Institute on Aging and other trusted resources—but made personal, practical, and doable. I’m also shedding light on a topic that often gets left out of the aging conversation: urinary incontinence. It’s more than an inconvenience—it can limit your physical activity, impact your confidence, and quietly chip away at your social life. We’re going to talk about it openly, and I’ll show you how addressing bladder health can support your overall well-being as you age.

Whether you’re already noticing changes or just want to feel prepared for what’s ahead, this episode is full of guidance you can start using today. 

For more information on today's topic:
www.nih.gov
www.cdc.gov
https://pubmed.ncbi.nlm.nih.gov/38383092/
https://www.nia.nih.gov/

Timeline:

00:28 Introduction to Aging Gracefully

01:34 Key Recommendations for Healthy Aging

02:56 The Importance of Staying Active 

08:46 Healthy Eating Habits 10:36 The Role of Quality Sleep 

13:31 Social Connections and Mental Health 

14:47 Proactive Healthcare and Final Thoughts 

15:54 The Impact of Bladder Health on Aging

Transcript

Hi there. Today, I'm gonna talk to you about aging gracefully. I've been a practicing physician for over 20 years. This means I've treated a lot of patients before. I experienced the condition. I took care of pregnant women and delivered them before I had ever been pregnant.

I've taken care of perimenopausal women long before I became perimenopausal myself, and I've taken care of menopausal women. Long before I had any menopausal symptoms, and I've always learned more about whatever condition it is once I've experienced it. There's something about going through something that teaches you just a little bit more.

As I've gotten older, I've started thinking more and more about aging gracefully. We've all met those women who are older, look great and are just so active and fit. How do they do it? So, this is gonna be the focus of the podcast today. What are the current recommendations for aging gracefully and what can you do to optimize your chances of being a fit, active older women?

Many of these recommendations are gonna sound like just good common sense, but let's go ahead and let's go through them. A lot of the information that I'm gonna share with you comes from the National Institutes of Health, um, specifically the National Institute of Aging. If you're interested in more information, you can find it@nih.gov.

And there's also good information on the Centers for Disease Control and Prevention website, which is CDC gov. So the National Institute of Aging recommends that you, one, stay active. Two, make healthy food choices. Three. Get enough sleep, and most adults average need an average of seven to nine hours.

Four, limit alcohol. Five. Be proactive regarding health and to get your screenings. Six. Don't smoke and seven. Seven, stay social and intellectually curious. None of this sounds too hard, but let's break it down and talk about this in more detail. So, one, stay active. I, I think this one may be the most important.

It makes sense, but what do you have to do? The activity recommendations are the same for all adults, no matter how old you are. The National Institute of Health and the American Heart Association have essentially the same recommendations, and they recommend that you get a minimum of 150 minutes of moderate intensity exercise per week.

So that is two and a half hours of moderate intensity exercise per week, which is 30 minutes, five days. Um.

75 minutes of vigorous exercise per week, which is one and a quarter hours, one and a quarter hours per week, or about 30 minutes three days a week. And that's if your exercise is vigorous. So why, how does this benefit you? Well, Gulati and all, um, recently published an article in the Journal of the American College of Cardiology in 2024, and research shows that this level of, um, exercise benefits everyone, but it benefits women more than men.

And if you achieve this level of exercise, you are 24% less likely to die early and 36% less likely to have a heart attack or stroke. The benefit of exercise increases the more you do, but when you hit that two and a half hours of moderate exercise per week, um, and it stays even after exercise. Um, but there isn't as much additional benefit at that point.

If you add in strength training to your exercise routine, you're 19% less likely to die and 30% less likely to have a significant heart issue. These results are true for any exercise. So the intensity is what is important. So you can do whatever you want. And I think that's really the key here, is to find the exercise that you like the best.

So you could go for a brisk walk, you could do spinning, you could run, you could jump rope, whatever is, you know, kind of best for you. The less time you spend sitting and the more time you spend moving, the better. There's also some recommendations that you should be active, so moving 300 minutes per week or five hours per week.

Exer exercise has been shown to improve cognition. Two. Um, especially as we age, and who wouldn't want that? So the people who are more physically active also tend to be more mentally acute and thinking a little bit better for women as we get older. Strength training and balance exercises become particularly important.

It's an unpleasant fact that our muscles waste as we age. This starts much earlier than you think: muscle wasting. Or in the medical world, we call a sarcopenia. Starts when our we're in our thirties. On average, we lose three to 8% of our muscles in each decade, and the wasting actually accelerates after we're 60 years old.

So if it starts at 30, by the time you're 50, you've lost somewhere between six to 16% of the muscle mass you had when you were younger. This makes strength training or lifting weights so important, especially after menopause, because it helps prevent this muscle wasting. It's also important to eat protein, but I'll talk about that just a little bit more later.

This loss of muscle mass always worries me. I, I want to always be able to hike, to do yoga, ride my bike, do whatever I want to do. Maybe you're not active and so this doesn't worry you as much, but it should. When you lose enough muscle, it limits your mobility, your ability to get around it makes it more likely that you'll fall.

It makes it harder to do all the things you want to do every day. Basic things like standing, walking, climbing up steps. It increases weakness, it increases fatigue, and it decreases energy levels. Balance exercises are important after 65, and this can be as simple as standing on one foot. Um, it takes a little bit of work to maintain your balance, so balance exercises are important.

So I think the message here is move sweat, lift heavy things. Stand on one foot when you don't feel like it. Remember that exercise strengthens your muscles. It increases your flexibility, it improves your energy, it helps you maintain your weight, and that's something that most of us need a little bit of help with.

It builds and maintains your bones. It prevents heart disease dia,betes, and even certain types of cancer. Exercise relieves stress, it improves sleep quality, it helps depression and anxiety, and you'll be more toned. Our daily lives today push us to be more and more sedentary and to move less.

Exercise is better than any pill or supplement on the market. Um, if we could market a pill that could do all of these things, everybody would be taking it. So do it. Get more active and exercise a little bit more. So let's talk a little bit about food. No one diet is really better than the other. The most important thing is healthy choices.

You wanna limit processed food, you wanna eat lots of fruits and vegetables. If you're eating grains, you wanna eat whole grains, you wanna stick to healthy fats, so monounsaturated or polyunsaturated fats. And these are found in foods like avocados, nuts, so almonds, peanuts, cashews, um, seeds like flax seed or chia seeds, oily fishes like salmon, trout, and sardines, and olive oil and vegetable oil.

You also wanna stick to lean protein. So think of things like skinless chicken breasts, skinless Turkey, breast fish beans, lentils, egg whites, Greek yogurt has a lot of protein, cottage cheese, even milk. The recommendations are pro on protein are that we eat 0.8 grams of protein per kilogram of body weight per day.

So, 0.8 of protein per kilogram of body weight. This is more protein than most of us eat if we're not trying and deliberately adding more protein to the diet. The Menopause Society also recommends that you eat that. You take between a thousand to 1200 milligrams of calcium per day, plus one to 2000 units of Vitamin D today.

Vitamin D per day to help prevent osteoporosis. As important as what you eat is, it's also important what you're not eating or shouldn't. Alcohol, while enjoyed by many of us, doesn't really help us. It's been associated with premature aging, and it has a negative effect on heart health. It's also been associated with certain types of cancer.

And smoking is also a big no-no for aging. Gracefully. Smokers are three times more likely than non-smokers to die early. So the message here is to eat in moderation, increase your vegetables, stick to healthy fats, increase your protein, minimize alcohol, don't smoke, and make sure you take your calcium and vitamin D.

So the next thing that I'm gonna talk about is sleep. And I think a lot of us take sleep for granted, but there's been a lot more research on sleep. And how important is it for our overall health? Most adults need seven to nine hours, um, per night. It's important to get this much, and it has to be good quality sleep.

Many of us need to improve our sleep hygiene. So what does this mean? Sleep. Hi. Sleep hygiene is really about creating a routine that promotes sleep. So it's about going to bed and waking up at the same time. It's about keeping your bedroom dark, quiet, and cool. It's about doing relaxing activities before bed, so maybe reading or taking a bath or using relaxing techniques.

The recommendations are also to limit electronic devices because the blue light is stimulating 30 to 60 minutes before bed, and then avoid naps, avoid alcohol, and avoid caffeine before bed better. Sleep has been shown to decrease irritability and depression. It improves forgetfulness. A lack of sleep has been associated with high blood pressure, heart disease, and diabetes.

Lack of sleep also has a negative impact on memory. It increases stress, and it's also been shown to increase your fall risk. As we get older, sleep patterns change. It's more common to go to sleep earlier. It's more common to wake up earlier. It's more common to wake up multiple times at night or to want to nap, and all of this means that you may have to be more deliberate in your habits to make sure that you are getting good sleep.

This is actually something that I've always been really good at. I've always really liked sleep and I value a great night of sleep, and I think life's just a little bit easier when I'm well rest. So I'm gonna switch now and talk about social connections, um, because I think this is something that we don't necessarily think about or focus on, and social connections are always important, but become even more important as we age.

Women who age gracefully have strong social connections and regular interactions with other people. They're not socially isolated. And this is something that commonly happens as we age in our society. This means that these women often have hobbies that draw them outside the house and are actively involved in social and leisure activities.

When I look at my own patients, I have often thought that my patients who are golfers age the best. I think this is because they're physically active and they're also engaged in a social activity that involves people of all ages. It makes me wish that I like to golf, but I do not. I can't stress how important these social interactions are.

Women who are socially isolated have a greater risk of heart disease, depression, cognitive decline, and memory issues. It also obviously decreases quality of life and wellbeing. We're social beings, so go out with your friends, maintain those friendships, try new things, learn new skills. All of this helps.

The aging process. Learning new things has been shown to increase cognitive ability in all ages. So don't be afraid to try something new or to make new friends. The last thing is it's just important to be proactive with your healthcare. It's important to get your screenings done, pap smears, mammograms, colon cancer screening, blood pressure screening, diabetes screening, and it's important to have a relationship with your doctor before you have health problems and need that doctor so that you have an established relationship.

So the takeaways here, move and exercise regularly. Lift heavy things and work on your balance. Eat a high quality diet. Sleep well, minimize alcohol and don't smoke, and be social and learn new things. Studies have shown that these healthy lifestyle factors like physical activity, no smoking, minimum minimal alcohol, a healthy diet, and engaging in mentally stimulating activities, decrease the risk of Alzheimer's by about 60% if you're engaged with more than four of those activities.

So. You may be wondering why I think all of this is so important as a urogynecologist. This isn't just personal for me. I also think this is important at work. Um, and there are a lot of reasons. One is that these are common sense interventions that will help everyone, and I want my patients to be as healthy as possible.

But me, maybe even more importantly to me is that I think bladder leaking leads to aging poorly and why? It's a little indirect, but it goes like this. Research has shown that about two thirds of the US women view urinary incontinence as a barrier to physical activity, meaning that if they leak, they're less likely to be physically active.

And research has also shown that bladder leaking is associated with feelings of social isolation, more loneliness, depression, sadness, and women are less likely to go out and be socially active. Because aging gracefully depends so much on being active and being social, urinary incontinence makes it more difficult to age gracefully.

We need to be active, we need to be social, and incontinence gets in the way of all of this. I think we underestimate the impact that bladder leaking has on our overall health over time. So if you feel like you are starting to change your activities, you're giving things up, you're not as social as you used to because of your bladder leaking, it's time to do something.

And I would say let's go ahead and get started.