More than almost any other group, modern middle-aged American women face ongoing stress that is seriously affecting their general well-being. Women in their late 30s through their late 50s often work full time, tend to children or grandchildren and act as caregivers to physically or mentally failing parents.
Physician and cardiologist Nieca Goldberg says those women in particular need to take time to take care of themselves before they end up suffering physical and emotional difficulties that could cause serious health problems. "Women are often so busy that they don't take time for themselves, and they often don't get regular checkups," says Goldberg, author of "Dr. Nieca Goldberg's Complete Guide to Women's Health" and a spokeswoman for the American Heart Association. "No matter how old you are, you should take care of your health, but you need to be even more vigilant after age 35. Everyone should get a checkup once a year. Of course, if something is wrong, you'll see the doctor more often."
Taking care of elderly parents is something that leads to loads of stress in women, many of whom are trying to "do it all" single-handedly, Goldberg says. "Women, especially those caring for elderly parents and families, have to find ways to prioritize their own health. They need to take breaks -- maybe find a sibling to help out.
"It's also good to have a support network. Try walking or yoga or meditation. Try doing something with a group, or maybe a vacation would help," she continues. "If you smoke, you need to quit. And be sure to get enough sleep."
Women who sleep for less than seven hours a night are at greater risk for high blood pressure and heart disease. Lack of sleep also is associated with increased cortisol levels, weight gain and Type 2 diabetes.
"Women need to turn themselves off. We're connected 24/7, but we need to find downtime by blocking computers and e-mail," Goldberg says. "You need to make time to exercise even if you don't have any." She says swimming is a good exercise for your heart, but it doesn't do much for your bones.
"To maintain good bone health, you need to do weight-bearing exercise," she says. "Walking is a great weight-bearing exercise. Walking on a treadmill works, too, as does dancing or any other kind of upright aerobic activity."
It's a well-known fact that women need calcium to prevent bone loss. Women between the ages of 19 and 50 require 1,200 milligrams of calcium a day, with 400 units of vitamin D to help with absorption. Women older than 50 should aim for a daily calcium intake of 1,200 to 1,500 milligrams a day, along with 400 units of vitamin D.
Finally, women need to understand that like men, they get heart disease, Goldberg says. In fact, heart disease is the No. 1 killer of women, and 1 in 2.6 women will die of a heart attack or another heart-related problem.
Risk factors for coronary artery disease (for both women and men) include family history of heart disease, smoking, elevated LDL (bad) cholesterol, low HDL (good) cholesterol, high triglycerides, diabetes, high blood pressure, obesity and a sedentary lifestyle.
"You can't do much about your family history of heart disease," Goldberg says. "But you can do something about a lifestyle that puts you at risk. If you don't exercise and you eat a high-fat diet or smoke, your chances of developing heart disease are much greater than they would be if you took reasonably good care of your physical well-being."
Goldberg says that more than anything else, she wants women to be knowledgeable and cautious about medical care. "I want to help women understand their bodies," she concludes. "I want them to know what's normal, what's common and what's suspicious."