For millions of women, this story will be a wellness wake-up call. That’s because in recent years, the numbers that define “normal” when it comes to blood sugar, bone mass and blood pressure have shifted. That leaves many of us in the new and perilous position of having a “predisease”: You don’t officially have diabetes or hypertension, for example, but you’re teetering on the edge of a diagnosis. “More than anything, these prediseases are a warning that you should make healthy lifestyle changes—like diet and exercise—now before a more serious issue develops,” says preventive medicine specialist Alex Krist, MD, MPH, an associate professor of family medicine and director of community-engaged research at the Virginia Commonwealth University Center for Clinical and Translational Research. Because these conditions are usually silent (meaning no red-flag symptoms), it’s easy to be unaware of or ignore the quiet peril they pose. Until now. Fight three of the most common precursor conditions we uncovered with our risk-reversing guide.
If you thought 120/80 was a good BP, we’re sorry to say you’re wrong. It’s actually the beginning of a danger zone. Prehypertension is defined as systolic pressure (the top number) between 120 and 139 mm Hg or diastolic pressure (the bottom number) between 80 and 89 mm Hg.
Who has it? A shocking one in three adults in the U.S., probably due to high obesity rates, our sedentary lifestyles and smoking.
How to monitor it: Have your blood pressure measured at least once every two years—more often if you discover you’re in risky territory.
“Prehypertensive blood pressure causes damage to your arteries that leads to even higher levels of blood pressure. It’s a snowball effect,” explains Dylan L. Steen, MD, director of clinical trials and population health research at the University of Cincinnati College of Medicine. “Without intervention, most people who have prehypertension will eventually develop hypertension.” Simply having the precondition increases your chances of heart attack, stroke and kidney disease.
Playing dietary defense: We may not be able to stop your blood pressure from soaring whenever your kid leaves clothes on the floor instead of in the laundry basket. But we can make yelling “Dinner’s ready!” a key to lowering your numbers. “Blood pressure can drop up to 20 mm Hg just with lifestyle changes, like diet and exercise,” says Steen. With its high content of the key minerals potassium, calcium and magnesium, the DASH (dietary approaches to stop hypertension) diet is a triple threat against high blood pressure. The proven plan is rich in fruits, vegetables, whole grains, poultry, fish and nuts, and low in sodium, saturated and trans fats, and sugar. Ditto the Mediterranean diet, which studies show also brings down pressure.
Regardless of the meal plan you choose, aim for five servings of fruits and vegetables per day. If you’re using canned veggies, beware that there may be sneaky sodium—fresh or frozen are better choices in this respect—so rinse those veggies before eating or heating them. Having a culinary attitude of gratitude also helps. Experts say you’re more likely to be a diet success if you focus more on what you can have (like grilled salmon, a healthy Waldorf salad) instead of what you should avoid (surprising salt traps like frozen pizza).
Go-to snack: Blueberries and low-fat Greek yogurt. According to a new study in the Journal of the Academy of Nutrition and Dietetics, consuming blueberries on a daily basis reduces systolic and diastolic blood pressure in postmenopausal women with prehypertension. Greek yogurt is loaded with BP-calming calcium and potassium.
Ideal dessert: A square of dark chocolate. A study from the University of Indonesia found that when people with prehypertension ate 30 grams (just over 1 ounce) of the delicious indulgence per day, they experienced a significant decrease in their systolic blood pressure after 15 days.
Last call: If you consume alcohol, stick with one drink per day (the definition of moderate for women). Overdoing it contributes to high blood pressure.
Movement Rx: Unroll a mat. A 2015 study from India found that doing 12 weeks of yoga helped people with prehypertension reduce their blood pressure significantly and return it to the normal zone. And even if you’d rather not strike a pose, doing any aerobic exercise for at least 40 minutes three to four days a week can help lower your numbers.
Also called impaired fasting glucose (IFG), this condition occurs when glucose levels fall between 100 and 125mg/dl—higher than normal but not elevated enough to be diabetes (126 or above).
Who has it? One in three American adults, with risk factors including being overweight, having a personal history of gestational diabetes and having a family history of type 2 diabetes.
How to monitor it? Your fasting blood sugar should be checked every three years starting at age 45, earlier and more often if it’s elevated or you’re at risk. “If you have prediabetes, you have an up to 10% higher risk of developing type 2 diabetes every year if nothing is done to prevent it,” says Joel Zonszein, MD, a professor of clinical medicine at the Albert Einstein College of Medicine. Preliminary research from the University of Wisconsin-Madison suggests prediabetes may have negative effects on the brain, impairing its ability to respond to stress. Alone, the condition raises your chances of heart attack, peripheral artery disease and more.
Playing dietary defense: Sticking with complex carbs (think veggies, whole grains and fruit) plus moderate amounts of lean protein may reduce your blood sugar. “Consider covering half your plate with fruits and veggies, a quarter with whole grains and a quarter with lean protein,” says Hillary Wright, RD, author of The Pre-Diabetes Plan. Some specific foods to add to your grocery list: beans (black, garbanzo, kidney), leafy greens (spinach, kale, chard), berries (blueberries, raspberries), tomatoes, salmon and other fish rich in omega-3 fatty acids, and nuts and seeds.
Go-to snack: A handful of pistachios. A 2014 study from Spain found that regular consumption of pistachios reduces fasting blood sugar and insulin levels in people with prediabetes.
Perfect breaskfast: A serving of oatmeal with a tablespoon of walnuts and raisins and a teaspoon of cinnamon. Research from Ball State University found that adding cinnamon to hot cereal leads to a slower rise in blood sugar after the meal, which helps with overall blood sugar regulation.
Spice surprise: Consider sprinkling a little turmeric into your next meal. The yellow powder reduces blood glucose in people with prediabetes and diabetes, according to several studies.
Movement Rx: HIIT it! The best form of exercise is the one you’ll do regularly—and by regularly, we mean 150 minutes a week. But some experts say a lower dose of high-intensity interval training (HIIT)—brief bursts of vigorous exercise, followed by bouts of lower intensity—gives you the best bang for your exercise buck. In fact, research from McMaster University in Canada discovered that after just one session of HIIT, blood sugar levels were significantly decreased for 24 hours among people with prediabetes and type 2 diabetes. “Your muscles are like a sponge that absorbs glucose after exercise,” explains Jonathan Little, PhD, an assistant professor in the School of Health and Exercise Sciences at the University of British Columbia’s Okanagancampus. “When you do HIIT, as opposed to steady walking, for example, you call upon more muscle fibers to do the work. So you have a larger sponge to drain glucose.”
A precursor to osteoporosis, this condition is a warning that your bones are becoming brittle. Osteopenia is defined as a T-score on a bone density test (dual energy x-ray absorptiometry) that’s between –1 and –2.5; osteoporosis is a score lower than –2.5.
Who has it? An estimated 34.5 million adults 50 years old and up in the U.S. suffer from low bone mass—and most of them are women. A family history of osteoporosis and a personal history of eating disorders, smoking and taking medications that decrease bone mass (such as PPIs, SSRIs, anti-seizure drugs, corticosteroids and aromatase inhibitors) up your risk.
How do you spot it? Ask your doctor about bone density testing if you break a bone after age 50, you’re over 65 or you’re menopausal and have risk factors (like a previous fracture). “As you approach menopause, you lose more bone,” explains Felicia Cosman, MD, senior clinical director of the National Osteoporosis Foundation. “The lower your bone density is, the more you need to pay attention to it.” Osteopenia and osteoporosis live on the same continuum, with osteopenia on the milder side. But that doesn’t mean it’s benign. Decreased bone density increases your risk of suffering a fracture from a minor fall (from standing height), a hug or a run-in with a piece of furniture.
Playing dietary defense: Load up on nutrients crucial for bone integrity: potassium (there’s plenty in winter squash and sweet potatoes), magnesium (you’ll find high amounts in almonds and beets) and vitamin K (try dark greens like collard greens and Brussels sprouts). Just watch out for calcium-sapping sodium. The National Osteoporosis Foundation recommends reducing your salt intake to a max of 2,400 mg per day. And, no surprise, make a concerted effort to get enough calcium (1,000 mg per day for women 50 and under, 1,200 mg daily for those over 50) and vitamin D (400 to 800 IU daily before 50, 800 to 1,000 mg daily after).
As for beverages, the jury is out on whether the phosphorus in cola drinks contributes to bone loss, but the carbonation is considered harmless. And no worries when it comes to your cup of joe, Cosman says, as long as you don’t overdo it (max out at four per day). If you’re still concerned, add milk to your coffee to mitigate the risk. And limit yourself to no more than two cocktails or glasses of wine per day.
Go-to snack: A handful of dried plums (okay, prunes) and a stick of low-fat cheese (loaded with calcium). New research from San Diego State University reveals that daily prune consumption helps reverse bone loss in postmenopausal women with osteopenia.
Best veggie for your bones: Kale—it’s rich in potassium and magnesium.
Powerful protein: Research from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University found that older adults who consume three or more servings of fish per week are able to maintain higher bone mineral density than those who dine less often on seafood. Opt for fish rich in calcium and omega-3 fatty acids (like salmon and sardines with bones).
Movement Rx: Feel the weight. Activities like walking, stair-climbing, jogging and tennis have something critical in common: They’re all weight bearing. Firm up your frame by doing them at least 30 minutes most days of the week and practicing strength training at least twice a week.