The midlife health mistakes a women’s health expert sees again and again
- Rob Kemp
Published: September 9, 2026 at 4:32 PM
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Don't fall into unhealthy habits – here's what to do instead
Your forties and fifties can bring some significant changes to your body – but blaming everything on hormones, sticking to the same exercise routine and ignoring some important health numbers could be mistakes. Here, Dr Amy McKenzie reveals the midlife habits worth rethinking.
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Midlife can feel like the moment when somebody quietly changes the rules. Sleep that once came easily becomes elusive, weight starts settling in different places, energy levels fluctuate and an exercise and eating routine that worked perfectly well for years suddenly doesn’t seem to deliver the same results.
Perimenopause and menopause inevitably get much of the attention – and with good reason. But one potential downside of our growing awareness of menopause is the temptation to attribute every physical and emotional change that happens in our forties and fifties to hormones.
At the same time, women who have spent decades thinking about their health primarily in terms of weight, diet and familiar screening programmes can overlook other measures that become increasingly relevant with age. Dr Amy McKenzie, medical affairs director for healthcare specialists Abbott’s Lingo, believes midlife should instead be seen as an opportunity to take stock and establish habits that could pay dividends for decades.
“Health doesn’t require a total overhaul overnight,” says Dr McKenzie. “The small changes you put into practice in your forties are in support of your decades to come.” So, what are the mistakes she sees women making – and what should we be doing differently?
Mistake 1: Knowing your weight – but not your health numbers
Most of us know roughly what we weigh. Far fewer could confidently reel off their latest blood pressure, cholesterol or blood glucose results. Yet Dr McKenzie argues that looking beyond the bathroom scales becomes increasingly important during midlife. “Women are often diligent about mammograms and cervical cancer screenings, but they might not know to check in on glucose and heart health in midlife,” she says.
One reason is the hormonal transition around menopause. Declining oestrogen is associated with changes in body composition and insulin sensitivity, while fat distribution can shift towards greater storage around the abdomen and internal organs.
Rather than focusing solely on weight, McKenzie recommends developing a broader picture of metabolic and cardiovascular health. “Knowing your glucose, waist circumference-to-height ratio, blood pressure and blood lipids like cholesterol and triglycerides tells you a lot about your health risk – and gives you the opportunity to take action early.”
The important message isn't to become obsessed with numbers, but to recognise that the scales provide only one piece of the health jigsaw. “We’re all aware of how our weight is tracking – seeing an upward trend on the scale or noticing if our clothes get tighter,” says McKenzie. “But weight is just one predictor of our long-term health. Glucose, blood pressure and cholesterol reveal more of the story.”
Mistake 2: Blaming everything on menopause
Fatigue? Menopause. Brain fog? Menopause. Poor sleep, low mood or unexplained weight gain? Menopause again.
Sometimes hormones really are responsible. But assuming they explain every new symptom can potentially mean other health problems are overlooked. “It’s incredible that women are more aware of menopause symptoms and what can be done to improve their quality of life,” says McKenzie. “But we shouldn’t assume that every instance of fatigue, brain fog, mood changes, weight gain, you name it, is due to menopause.”
That is because many of the symptoms associated with perimenopause and menopause overlap with other conditions. McKenzie points to type 2 diabetes, thyroid and sleep disorders and poor nutrition as possible alternative explanations.
Rather than attempting to diagnose the cause yourself, pay attention to changes that feel particularly pronounced or out of character. “Symptoms that change rapidly and significantly, that don’t go away or get worse, or those that affect your quality of life should be discussed with a healthcare professional.”
Mistake 3: Exercising only to burn calories
For years, exercise has often been sold to women primarily as a means of controlling weight: run, cycle or attend a high-intensity class and watch the calories burn. Dr McKenzie would like women to change that mindset in midlife. “The biggest shift in exercise I encourage women to make is to stop thinking only about what exercise burns and start thinking about what it can build,” she says.
Muscle and bone become increasingly important considerations as we age. Maintaining muscle isn't simply about looking toned; it supports strength, mobility and independence and plays an important role in metabolic health.
Nor does that mean swapping every run for the weights room. “A common mistake I see is women focusing on only one type of exercise like running or lifting,” says McKenzie. “The reality is that both matter. Strength training helps maintain muscle, bone and glucose health while cardio supports heart health and overall wellbeing.”
Her advice is to aim for resistance exercise two to three times each week and progressively increase the challenge as you become stronger. Cardiovascular activity can then be incorporated into everyday life through anything from purposeful walking and hiking to taking the stairs. “Mix and match your exercise,” she says. “Work cardio into your daily routine wherever you can – walking, taking the stairs, hiking – whatever fits your lifestyle and that you enjoy. But exercise is only one part of the equation, so be sure to prioritise protein in your diet and protect your sleep as well.”
Mistake 4: Eating exactly as you did at 20
There's no requirement to embark on a punishing “midlife diet” when you turn 40, but Dr McKenzie says assuming the body will respond to food exactly as it did decades earlier can also be a mistake.
“One of the biggest nutrition mistakes I see in midlife is women eating the same way at 50 as when they were 20,” she says. “How well we tolerate the carbs and sugars in our diet declines with age, so we have to learn to work with our new biology rather than against it.”
McKenzie works for a healthcare business which produces a continuous glucose monitor designed to show how glucose responds to factors including food, exercise, sleep and stress. However, you don't need a sensor to start improving the overall quality of your diet. Instead, focus on nutrient-dense whole foods, adequate protein and plenty of fibre. “A few nutrients deserve extra attention,” says McKenzie. “Salmon, tuna, eggs, Greek yogurt and green veggies are my personal favourites to get protein, fibre, vitamin D, calcium and omega-3s to support muscle, bone, glucose and heart health.”
In practical terms, she suggests building meals around whole-food protein sources such as fish, eggs, tofu or meat, accompanied by generous portions of vegetables. “For fibre, vitamins and minerals, leave plenty of room for broccoli, spinach, Brussels sprouts, artichokes or raspberries on your plate,” she says. “You can also sprinkle in some whole intact grains like brown rice, quinoa or bulgur.”
Mistake 5: Accepting bad sleep as your new normal
Hot flushes, night sweats and hormonal changes can all interfere with sleep during the menopause transition. But waking up exhausted every day shouldn't simply be regarded as another inevitable part of getting older.
“One of the biggest mistakes I see women make is thinking poor sleep is something they just have to put up with,” says Dr McKenzie. Another trap is trying to paper over the problem rather than identifying its cause. “I also see women trying to power through with caffeine during the day or sleep aids at night without finding and addressing the root cause,” she says. “The effects of poor sleep don’t stay in the bedroom. They can spill over to our mood, focus and even metabolic health.”
Persistent sleep problems can have causes other than menopause, including insomnia, obstructive sleep apnoea and restless legs syndrome. “If sleep problems are persistent, worsening or impacting how you feel or function during the day, it’s time for a conversation with a healthcare professional,” says Dr McKenzie. “Loud snoring or excessive sleepiness during the day are also common reasons to check in with your doctor.”
Mistake 6: Waiting until something goes wrong
Perhaps the biggest midlife mistake is treating health as something to worry about only after receiving a diagnosis. “Obesity, pre-diabetes, type 2 diabetes and heart disease develop over many years,” says McKenzie. “You can start making lifestyle changes when clothes start getting tighter or glucose levels start rising, rather than waiting for the diagnosis to come. Small changes early can go a long way.”
That doesn't mean having to transform your life at 40. Instead, think of midlife as the time to start laying foundations: know your important health numbers, eat in a way that supports rather than simply restricts your body, build and preserve muscle, look after your cardiovascular fitness and don't ignore persistent symptoms.
Above all, stop viewing healthy ageing solely through the prism of weight loss. “Calories count, but muscle strength and healthy food choices matter, too,” says Dr McKenzie. “Diversify your exercise routine with cardio to get your heart pumping and resistance training to build muscle strength.”
Your body may be changing in midlife, but that doesn't mean decline is inevitable. What you do now can help determine not just how you feel at 45 or 50, but how strong, mobile and healthy you remain in the decades that follow.
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Rob Kemp
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