Target: 80 percent of people engaged in leisure-time physical activity
Then: 58 percent of people 45 to 64 Now: 63 percent
More than a third of Americans in middle age do not perform even 10 minutes of light or moderate physical activity each day. And while that's an improvement from a decade ago—and better than their older counterparts (46 percent of those ages 65 to 74 are inactive)—it's not conducive to long-term health. "Even independent of body weight, we know that physical activity reduces risk of heart disease, stroke, and diabetes," Manson says.
Here too, experts place at least some blame on the environment. The Centers for Disease Control and Prevention recommends that midlife adults do 2½ hours of moderate-intensity movement (like brisk walking) each week, in addition to muscle-strengthening activities. "But it's very difficult for people to follow these recommendations when they don't have sidewalks in their communities, well-lit parks, or other safe areas," Manson says. Health experts have taken note: One new goal expected to be part of Healthy People 2020 is creating social and physical environments that promote good health. For now, those whose neighborhoods aren't conducive to outside activities should consider joining a gym or community sports league, walking laps at an indoor mall, or working out to an exercise DVD at home.
Target: 25 cases per 1,000 people
Then: 76 per 1,000 people 45 to 64 Now: 120
Until the obesity and exercise numbers improve, it's unlikely the numbers for diabetes will either. "I tell my patients, 'To avoid diabetes, if you want to eat like you live on a farm, you have to work like you live on a farm.' How many of us do that?" says Stuart Weiss, clinical assistant professor of medicine at New York University School of Medicine.
People with a diagnosis of diabetes must take immediate action to control their glucose, which means losing excess weight, improving their diet, starting an exercise routine, and taking medication if necessary. "The research is clear that early and aggressive management of the disease prevents complications more than anything a person might do later," Weiss says. These complications can include heart disease, stroke, kidney failure, blindness, and nerve damage. Weiss advocates getting help from a nutritionist (typically covered by insurance) and a support group at a hospital or other institution. One key to staving off the disease is keeping weight under control. A recent study by University of Washington researchers found that, similar to previous reports on younger adults, weight gain after age 50 increases diabetes risk.
Fruits and vegetables
Target: 75 percent eating sufficient fruit; 50 percent for vegetables
Then: 39 percent for fruit, 4 percent for vegetables (all ages) Now: For fruit: 38 percent of men and 39 percent of women ages 40 to 59. For veggies: 6 percent of men and 4 percent of women
Just two daily servings of fruit and three of vegetables (one being dark green or orange) are enough to meet the target, yet few people get there. "Even that figure is inflated, because juices count as fruits although they're not as healthful," says Katz of the Yale center.
To reach this goal, people need to overhaul their eating patterns. "Rather than meat and potatoes, we have to start thinking of plant-based foods as the foundation of our diets," Katz says. Load berries onto morning cereal, begin supper with a veggie-rich salad, and think of stir fries and stews as dinnertime staples. Take fruit and sliced raw vegetables for a snack at work. (It's also fine to toss a little Parmesan cheese or some herbs in olive oil on top of those veggies.) "Sure, you could go out and buy a banana in the middle of the afternoon, but at that point you'll be more likely to dash out for a doughnut," Manson says. If you think you don't like a certain vegetable, try it again. "We tell parents to give a food to their child six or seven times before their palate comes to accept it. The same repetition is necessary for adults," Katz says.