By the time people reach midlife, many have the wisdom they lacked in their 20s, a clearer sense of where their life is headed and fewer concerns about what others think.
But this stage of life also brings a wave of changes that can make it feel as though you’re starting all over again.
Aside from the dreaded ‘midlife crisis’, hormonal shifts such as menopause and a slowing metabolism can make it easier to gain weight, particularly around the midriff, leaving many feeling as though their bodies are working against them.
Amid these changes, many forget that midlife – officially defined as between the ages of 40 and 65 – can also bring a serious problem: an increased risk of heart disease, an umbrella term for a range of conditions that affect the blood-pumping organ and the arteries leading into it.
As a result of natural ageing and lifestyle factors – obesity and overweight rates tend to surge at this age in the UK – blood vessels tend to become less flexible, and blood pressure and cholesterol rise, both of which are triggers for heart disease.
But according to Dr Oliver Guttmann, a consultant cardiologist at the private HCA Wellington Hospital in London, a number of seemingly harmless everyday habits – from choosing seemingly healthier ‘fat-free’ foods to the time you go to bed – could also be quietly increasing the risk of heart disease.
He told the Daily Mail: ‘I don’t think most people in their 40s and 50s are thinking about heart disease at all. They’re too busy – juggling work, kids, sometimes ageing parents too – and heart health just isn’t on the radar until something actually happens. They thought this was a problem for later in life, for when they’re older.’
We asked Dr Guttmann for his expert opinion on the simple lifestyle changes people in midlife can make to reduce their risk of heart disease, which claims the lives of around 170,000 Britons every year.
Dr Oliver Guttmann says a number of seemingly harmless everyday habits could be quietly increasing the risk of heart disease
When you eat may matter
Many people in midlife have reached senior positions at work, with longer hours and packed schedules often pushing dinner later into the evening.
But according to Dr Guttmann, eating too close to bedtime could be problematic.
He said: ‘Eating close to bedtime forces the body to manage a large metabolic load – digestion, insulin response – right when it should be winding down.
‘This is linked to poorer nutrient metabolism, disrupted sleep, and over time, higher risk of weight gain and metabolic syndrome, both of which feed into heart disease risk.’
Research has consistently linked late-night eating with a greater risk of obesity, which raises the risk of serious complications including type 2 diabetes and heart disease.
Over time, excess weight can damage the arteries, allowing fatty deposits to build up.
If these block the arteries supplying the heart, they can trigger a heart attack. If they affect blood vessels supplying the brain, they can also increase the risk of stroke and vascular dementia.
A study in 2022 by Harvard Medical School found that overweight or obese adults who ate the same meals around four hours later in the day felt hungrier and burned fewer calories, suggesting meal timing may play a role in weight gain and, ultimately, heart health.
‘Fat-free’ options may not be better
Walking through supermarket aisles, it can be tempting – particularly for those looking to shed weight – to reach for foods labelled ‘fat free’.
From yoghurts and cheeses to popular condiments, there is no shortage of products marketed as the healthier choice.
Dr Guttmann, however, advises looking beyond the front of the packet, warning that removing fat often means products may contain additives that may also be harmful to health.
He said: ‘When fat is stripped out, manufacturers often add sugar, salt, or thickeners to compensate for lost taste and texture.
‘So a ‘fat-free’ label can mask a product that’s actually worse for cardiovascular health than the full-fat version, particularly where refined sugar is the substitute.’
Many fat-free products contain these added sugars and extra salt, which can increase the risk of heart disease and weight gain.
Some also contain thickeners and stabilisers, such as xanthan gum, to improve texture.
While these are generally considered safe by food regulators, some people report digestive side effects such as inflammation, bloating or diarrhoea when consuming large amounts.
Heart disease – the umbrella term for a range of conditions that affect the heart – kills around 170,000 people every year in Britain
Hidden salt can catch you out
It’s not just fat-free products that deserve a closer look, says Dr Guttmann.
Many foods that appear healthy at first glance can contain surprisingly high amounts of salt, potentially increasing the risk of high blood pressure.
High blood pressure is the leading preventable cause of stroke, and Britain’s fourth biggest killer per year.
He said: ‘Many products marketed as healthy – flavoured yoghurts, soups, sauces, even bread – carry surprisingly high salt content used to enhance flavour or preserve shelf life.
‘People are far more salt-aware when eating crisps or ready meals than when reaching for something branded as nutritious, which is exactly what makes hidden salt so dangerous – it’s consumed without suspicion.
‘This can contribute to high blood pressure and increase the risk of heart disease and strokes.’
Dr Guttmann’s warning is backed up by national data showing that much of the salt in the average British diet is hidden in everyday foods rather than added at the table.
Public Health England estimates that around three-fifths of the salt Britons consume has already been added to processed foods, while just 15 to 20 per cent comes from salt added during cooking or at the table.
Consistent sleep times are important
It’s not just avoiding late-night meals that matters – keeping a regular bedtime could also help protect your heart.
A 2024 study led by researchers at the University of Ottawa, which analysed data from more than 72,000 UK adults, found that people with irregular bedtimes and wake-up times were 26 per cent more likely to suffer a heart attack or stroke than those who kept a consistent sleep schedule, even if they got the recommended amount of sleep.
Dr Guttmann said: ‘Irregular sleep patterns disrupt the body’s circadian rhythm, which plays a key role in regulating blood pressure and cortisol – the body’s main stress hormone.
‘Going to bed at wildly different times each night keeps the cardiovascular system in a state of flux rather than allowing it to settle into its natural nocturnal dip in blood pressure.
‘Over years, this can contribute to sustained hypertension (high blood pressure), which is one of the biggest drivers of heart disease.’
Sitting for a long time may harm heart health
With more people working from home since the Covid pandemic and spending hours at a desk, many Britons are moving less than ever before.
But experts have consistently warned that prolonged periods of sitting can increase the risk of developing serious heart problems, even among those who exercise regularly.
Worryingly, just one in three adults in the UK achieves at least 30 minutes of physical activity a day, while around 20 million fail to meet the recommended minimum of at least 150 minutes of moderate exercise each week.
And Dr Guttmann warns that prolonged periods without physical activity could be a growing driver of heart disease.
He explained: ‘Sitting for long stretches slows circulation, reduces insulin sensitivity, and is independently associated with higher cardiovascular risk – even in people who exercise regularly.
‘It’s not just about calories; prolonged stillness affects vascular function in ways a single workout doesn’t fully offset.’
The good news is that even small bursts of movement can help, as a study published last month in the British Journal of Sports Medicine found that taking five-minute walking breaks throughout the working day can improve health.
