Which screenings and check-ups are appropriate for my age?
Which screenings are appropriate for your age varies by individual, but a few anchor points are well supported: annual mammography from age 40, colorectal cancer screening from age 45, and genetic prenatal testing for all pregnant women.
For children between the ages of 2 and 12, every medical visit should include a BMI measurement, a blood pressure check, and at some point a blood lipid test. In practice, this falls short far too often: BMI was measured in 77 out of 100 cases, blood pressure in only 33 out of 100, and the blood lipid test in just 10 out of 1001. As a parent, it is therefore worth raising this yourself at a consultation.
Are you pregnant? Genetic screening is now available to all pregnant women, not just older mothers as was previously the case. Tests for chromosomal abnormalities such as Down syndrome, cystic fibrosis, and sickle cell disease are offered as standard2. Children with Down syndrome have their own age-specific benchmarks for motor skills, language, and independence, so that developmental delays can be detected early3.
For women, mammography is the only scientifically supported method for reducing deaths from breast cancer. The recommendation for women at average risk is: start annually from age 404. Have you previously had breast cancer? If so, the current age thresholds for follow-up are insufficient, because the type of treatment you received carries at least as much weight5. Discuss this individually with your doctor.
According to US guidelines, cervical cancer screening may be stopped after age 65. This advice is largely followed: the percentage of women having a cervical smear test drops by almost 6 percentage points as soon as they turn 66. However, this effect differs considerably between population groups6. The guideline therefore does not land equally well for everyone.
For colorectal cancer screening, the American Cancer Society lowered the starting age from 50 to 45 in 2018, due to rising rates of colorectal cancer in younger adults7. However, there is barely any direct evidence that screening in 45- to 50-year-olds actually reduces mortality. The recommendation is running ahead of the science.
The claims come from observational studies, guideline documents, and registry data (PMIDs 39450715, 37182584, 36410354, 31098760, 32510767, 18388816, 39279536). No randomised trials or meta-analyses were used as direct sources. Most statements are based on guideline recommendations or associations derived from data, not experimental evidence. For people between the ages of 20 and 40 without pregnancy or a specific condition, no particular statements were made in these sources.
Should I take vitamin B12 supplements as I get older?
Getting older increases the risk of a B12 deficiency, even if you eat healthily. Supplementation of 1000 micrograms per day is safe and corrects that deficiency effectively. Not sure? Then have your methylmalonic acid (MMA) measured alongside your B12 blood level -- that is the most reliable measure.
Do older adults need more protein than younger people?
Older adults likely need more protein than the standard guideline of 0.8 grams per kilogram suggests. As a healthy older adult, aim for 1.0 to 1.2 grams per kilogram per day, spread well across meals, and combine this with resistance training where possible.
Does eating a high-fibre diet help against constipation as you get older?
Eating more fibre helps against constipation in older adults, but the overall dietary pattern counts at least as much as fibre grams alone. Always drink sufficient water when taking fibre supplements, and consult your doctor if you use medications or have difficulty drinking enough.
How many years does smoking cost me, and does quitting still help?
Smoking demonstrably costs years of life expectancy at the population level, but a precise personal figure cannot be given on the basis of this research. Quitting always helps, at any age: the sooner you quit, the greater the gain.
Do antioxidant supplements make sense?
For healthy people, antioxidant supplements such as beta-carotene and vitamin E are not useful as protection against cancer or heart disease, and beta-carotene is frankly inadvisable for (ex-)smokers. The only well-supported exception is the AREDS formula for advanced macular degeneration: discuss this with your ophthalmologist.
How much fibre do I need and why?
Aiming for 25 to 29 grams of fibre per day is well supported and delivers the greatest health benefit. Most people in Western countries fall far short of that, so eating more vegetables, legumes and whole grains is a smart move for almost everyone.