A preventive cardiologist has outlined five evidence-backed habits that can help protect the heart, preserve muscle and keep people healthier for longer, regardless of age. Dr Francesco Lo Monaco, a preventive cardiologist at the National Longevity Clinic, says getting older does not mean fitness has to decline.
With ITV's Tonight set to explore How to Stay Fit as You Age on Thursday (October 15), the doctor explains that staying active is about more than keeping weight down or looking younger. Regular physical activity can help protect heart health, improve strength and balance, and reduce the risk of several long-term conditions.
He also says an expensive gym membership or an extreme fitness regimen is not required to start seeing benefits.
Start moving, even after years of inactivity
One of the biggest misconceptions about exercise is that it is only worthwhile if done regularly or at high intensity, he says. In reality, even small increases in physical activity can be beneficial. Walking, cycling, swimming, dancing and gardening can all help people become more active, and the best starting point is an activity they can comfortably maintain.
UK guidance recommends that adults aim for at least 150 minutes of moderate-intensity activity a week, building up gradually from their current level. Moderate activity should make you breathe faster and feel warmer, while still allowing you to hold a conversation.
Dr Lo Monaco said: “You don’t need to transform your lifestyle overnight. If you have become less active, start with something manageable, such as a daily walk, and build from there. Consistency matters far more than attempting an ambitious programme that you struggle to maintain. The aim is to find activities you enjoy and make them part of your normal routine.”
Build strength alongside cardio
Walking and other aerobic activities are important, but maintaining muscle strength becomes increasingly valuable as we age. Muscle strength helps with everyday tasks such as climbing stairs, carrying shopping and getting up from a chair. Strength and balance exercises can also help older adults maintain mobility and reduce their risk of falls.
Activities such as lifting weights, using resistance bands, Pilates and exercises using your own body weight can all help build or maintain strength. UK guidance recommends muscle-strengthening activities on at least two days a week, alongside regular aerobic activity.
Dr Lo Monaco said: “Cardiovascular fitness is only one part of healthy ageing. Maintaining muscle strength and balance can help people remain independent and continue doing the things they enjoy. You don’t necessarily need heavy weights or complicated equipment. The important thing is to choose exercises appropriate for your ability and increase the challenge gradually.”
Know your heart-health numbers
Feeling fit does not automatically mean cardiovascular risk is low. High blood pressure and raised cholesterol, for example, can develop without obvious symptoms. Understanding personal risk factors can help people make informed decisions about their health. Blood pressure checks, cholesterol testing and discussions about family history can all form part of a preventative approach.
Exercise can help improve blood pressure and cholesterol levels, but lifestyle changes are not a substitute for medication when it is needed. Dr Lo Monaco said: “One of the most useful things people can do is understand their own cardiovascular risk rather than relying on how well they feel. Blood pressure, cholesterol, smoking, family history and existing medical conditions all help build a picture of someone’s health. Knowing those factors gives you and your healthcare professional a better starting point for deciding what action may be appropriate.”
People should discuss their individual risk and the health checks suitable for them with their GP or another qualified healthcare professional.
Break up long periods of sitting
A regular workout is beneficial, but it is also worth considering how much time is spent sitting during the rest of the day. Long periods of inactivity can be broken up with short walks, standing while taking a phone call or moving around the house between tasks. For people who find structured exercise difficult, these small changes can provide a manageable starting point.
Dr Lo Monaco said: “People can sometimes think in terms of an all-or-nothing approach - either they have completed a proper workout or they have done nothing. But movement throughout the day matters, too. Building more activity into everyday life can be a realistic way to get started, particularly if you have been sedentary for a long time.”
Make changes you can stick to
Dramatic fitness challenges and ambitious lifestyle overhauls can be appealing, but they are not essential for improving long-term health. A more sustainable approach is to choose a few realistic habits, build them into your routine and adjust them as fitness and circumstances change.
That might mean walking more regularly, adding two strength sessions a week, taking the stairs when comfortable or arranging a health check to understand cardiovascular risk. Dr Lo Monaco said: “Healthy ageing isn’t about chasing a perfect routine or trying to reverse the clock. It is about making choices that support your health over time. Small, consistent changes can be much more realistic than trying to change everything at once.”
The cardiologist says starting with gentle activity and progressing gradually is a sensible approach. However, anyone who has been inactive for a long time, has a diagnosed medical condition or is concerned about their health should speak to a healthcare professional before beginning a new or strenuous exercise programme. Stop exercising and seek medical advice if you experience any concerning symptoms. Chest pain, severe breathlessness or collapse during exercise require urgent medical attention.
