Scroll through TikTok and you’d be forgiven for thinking the only people who care about health are in their twenties, downing green powders and collagen shots like their lives depend on it. But midlife brings a different kind of reckoning.
In your forties and fifties, the focus shifts from quick fixes to long-term gains – what will help you stay strong and sharp not just now, but for the decades ahead.
Hormones start to fluctuate, energy dips hit harder and advice on what to eat becomes increasingly chaotic. So what does midlife really ask of our diets – and how much of the hype is actually worth listening to?
Before we get into what to change, it’s worth understanding why our nutritional needs shift in the first place.
Hormonal changes play a central role. “Testosterone appears to be the central hormone involved in the development of sarcopenia [age-related muscle loss],” says Dr Linia Patel, women’s health dietitian and author of Food for Menopause. “In men, there is a reduction in testosterone by 1 per cent each year, leading to reduced muscle mass.”
It’s similarly bleak for older women: “Menopause is a period of immense hormonal transition that is linked to a loss in muscle mass and an increase in fat mass. Overall, menopause impacts how well we use carbohydrates, our levels of systemic inflammation and also our gut health.”
Other health markers start to shift, too. “Men are always at risk of heart disease. However, post-menopause, women catch up with them,” she adds. Bone health also takes a hit: “In Western cultures, it is estimated that people lose about 0.5 per cent of bone mass each year after the age of 40. Women, when they hit their forties, typically lose bone mass at a drastic rate during menopause when bone-protecting oestrogen levels drop. Around 10 per cent of a women’s bone mass is lost in the first five years of the menopause.”
All of which helps explain why what worked for us in our twenties and thirties may no longer cut it.
Protein: the midlife buzzword
If the snack aisle is anything to go by, we’re a nation obsessed with protein. But are we all walking around deficient? Not quite.
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(Getty/iStock)
“Most healthy adults in the West already get more than enough protein,” says Dr Federica Amati, head nutritionist at ZOE and nutrition lead at Imperial College London. “In the supermarket, with all the ‘high-protein’ snacks on the shelves, you could be forgiven for thinking that we are all protein deficient, but it’s just a marketing ploy.”
That said, our requirements do shift as we age. Amati explains that while protein needs remain fairly stable through adulthood, they rise slightly post-menopause and after age 65. “As adults, we need around 1 gram per kilo of body weight per day. So if you weigh 70kg, you would need approximately 70g of protein per day,” she explains. “If you are 65 or over or going through perimenopause or menopause, then you should aim for 1.2g per kg per day.”
Patel adds that the old guidelines are outdated. “Protein needs are highly individual, but we now have better ways of estimating what’s optimal, especially for midlife women,” she says. “The UK RNI (reference nutrient intake) for protein is 0.75g/kg/day. That number was based on older nitrogen balance studies, [which is] useful for preventing deficiency, but not for promoting strength or metabolic health.” Newer research suggests midlife women should aim for 1.0-1.2g/kg/day, especially during hormonal transitions, a threshold that is particularly important for older adults, active individuals and those wanting to preserve muscle mass and metabolic health.
There’s also something to be said for when you eat it. Patel advises spreading intake evenly across the day and “front-loading your meals with protein early to help satiety, blood sugar control and energy”. But, she warns against overdoing it: “More isn’t always better. Going above 2g/kg/day usually offers no added benefit – and it can actually displace other essential nutrients, especially fibre, which is key for gut health and the gut-muscle axis (yes, your gut health influences muscle health, too).”
Professor Bernard Corfe, who researches protein and ageing, puts it into perspective: “30g [of protein] can be quite a tall order at breakfast, and very few older adults achieve this.” Instead, he suggests “progressively increasing protein, adapting to change and not worrying if you miss the odd day – think of positive change in the long term”.
Holding on to muscle
Sarcopenia – the gradual loss of muscle mass – is one of the big concerns in midlife, and it’s not exclusive to the over-seventies. Corfe notes: “Some evidence suggests muscle loss can start as early as in your thirties, accelerating over time with loss rates increasing past 60,” but “it is very possible to maintain muscle through midlife and older adulthood through a diet rich in protein, coupled with an exercise plan that includes resistance work.”
The good news? It’s possible to slow or even reverse the loss. All three experts agree that protein alone isn’t enough – it needs to be paired with movement.
Know you. There is no one diet that works for everybody. You have to find a diet that is nourishing for you, sustainable to follow and that you enjoy.
Linia Patel
“To combat sarcopenia, the two things you need to focus on are consuming adequate protein – more isn’t necessarily better – and you need to keep physically active,” says Amati. That physical activity is “the critical driving force to maintain healthy muscles. Just a daily walk around the block is a start. It’s important to try some resistance exercise, too. This might just be doing some arm curls with tins of beans or leg lifts while you sit in a chair. We can’t build or maintain muscles unless we are using them.”
Patel highlights the stats: “Between the ages of 30 and 60, the average adult loses about 250g of muscle each year. At the age of 70, muscle loss accelerates to about 15 per cent per decade.”
Remember: don’t assume high protein equals muscle mass. It doesn’t work without resistance training, says Patel. “Muscle needs stimulus to grow. Protein is just the building material, not the architect.”
Brain food
Memory lapses, brain fog and mood shifts often sneak in around midlife. Diet won’t stop time, but it might soften the effects.
“As we age, our cognitive abilities tend to decline,” Amati acknowledges, “although age can affect people very differently, and some can remain as sharp as a tack into their nineties.”
So what helps? “Diet can certainly help reduce your likelihood of swift cognitive decline, but rather than focusing on nutrients, focus on quality and diversity,” she says. “Aim to eat 30 plants per week, including nuts, seeds, fruit, veg, pulses and legumes. The more different plants you eat, the more nutrients and healthy plant compounds you will consume.” She suggests trying to eat the rainbow: “Polyphenols give plants their colours, so by choosing different coloured plants, you get a wider range of polyphenols,” which help protect against chronic diseases like cardiovascular disease, neurodegenerative diseases and certain cancers.
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Fibre is the forgotten nutrient – we should be aiming for 30g a day (Getty)
Patel lists some brain-friendly nutrients worth adding to the mix: “Omega-3 rich foods – they are the building blocks of your neurones. Choline – a B vitamin that we aren’t getting enough of in the UK (found in eggs), is one of the key nutrients affecting major brain processes. Creatine? The new supplement on the block (well, it’s been around in sports for ages), its effects beyond performance sports are more and more promising, even linked with brain health, particularly for women in the menopause and beyond.”
One underrated brain booster? Water. “Hydrate!” Patel says. “Your brain shrinks when you are mildly dehydrated.”
Fibre, sleep and sugar
If sleep becomes elusive in midlife, your diet might be partly to blame. Amati notes: “There’s some evidence that reducing your intake of added sugars might help you sleep better. It’s also a healthy choice to cut down where you can, so that’s worth a try. There’s also evidence that increasing your fibre intake could help you get better sleep.”
We still don’t fully understand why, she says, but it could be linked to inflammation and blood sugar stability. “Either way, we know fibre-rich plants are good for you, so fill your basket!”
Patel agrees that fibre is essential and often overlooked. “Fibre is the forgotten nutrient but it is so, so good for us. Aim for 30g a day as a minimum. Start by swapping all your refined grains for wholegrains. Next, add in more pulses. Slow and steady fibre.”
The heart of the matter
Heart disease risk climbs in midlife, especially for women post-menopause. So what should we be eating if our cholesterol numbers start creeping up?
Most healthy adults in the West already get more than enough protein. In the supermarket, with all the ‘high-protein’ snacks on the shelves, you could be forgiven for thinking that we are all protein deficient, but it’s just a marketing ploy
Federica Amati
“Certain foods can help you lower your cholesterol levels,” says Amati. “These include oats, which contain a type of fibre called beta-glucan, which binds to cholesterol so that you poo it out. Also, nuts and seeds contain polyunsaturated ‘good’ fats, which help reduce levels of ‘bad’ cholesterol. A high fibre diet is an effective way to help protect our heart health.”
But more important than any one food is the overall pattern. “Rather than focusing on individual foods, follow a plant-based, diverse diet, like the Mediterranean diet, and your cholesterol levels should slowly move towards the healthy range,” she says. “It won’t happen overnight, though, so stick with it. Your gut microbiome will thank you, too.”
Patel highlights other evidence-based eating patterns, from the Dash (dietary approaches to stop hypertension) diet to the portfolio diet, as well as Heart UK’s Ultimate “cholesterol lowering plan”. Her advice? Start small. “While the benefits of these diets are well-established, adopting them can be challenging … I often advise to start with small, manageable changes you can build upon over time to have an impact.”
For example, “swapping half the meat in a bolognese for plant-based alternatives like lentils or chickpeas is a simple yet effective way to lower LDL cholesterol. Not only is it better for your heart, but it’s better for your wallet, too!”
She also suggests “having oats as a breakfast option at least two or three times a week, having a handful of unsalted, unroasted mixed nuts as a snack [and] eating at least two portions of fish per week.”
Small actions, she says, can have a cumulative impact.
A simpler plate
When asked what three changes she’d suggest to someone in their forties or fifties who wants to age well, Amati is clear: “Aim for 30 different plants per week. Cut down on high-risk processed foods. Eat the rainbow.”
Patel’s version is equally practical: “Know you. There is no one diet that works for everybody. You have to find a diet that is nourishing for you, sustainable to follow and that you enjoy.”
And if it all feels like a lot to take in, Corfe offers the reminder we all need, whatever our age: “It’s emphatically the case that it’s never too late to make changes and see health outcomes from those changes.”
Dining and Cooking