You Don't Have to Stop Doing What You Love to Get Healthier After 40
Healthy aging isn't about giving up fishing, boating, golf, hunting, travel, or the other things you enjoy. It's about taking care of your health so you can keep doing them.
There comes a point somewhere around 40 when many of us realize our bodies don't respond quite the way they did when we were 25.
Maybe you don't recover as quickly after a long day on the water.
Maybe the cooler feels a little heavier than it used to.
Maybe climbing in and out of the boat takes a little more effort.
Maybe you've gained some weight around your waist even though you don't think you've changed your lifestyle very much.
Or maybe you simply notice that you don't have quite the same strength, energy, or stamina you once had.
It's easy to write all of that off as:
"I'm just getting older."
Some changes are a normal part of aging. But getting older doesn't mean you have to stop being active, stop enjoying your hobbies, or accept losing your ability to do the things you love.
I think we sometimes have the wrong idea about what healthy aging is supposed to look like.
Healthy aging doesn't mean becoming obsessed with the scale, spending two hours every day in the gym, or completely reorganizing your life around your health.
It means maintaining enough health, strength, and physical capacity to continue living the life you enjoy.
If you love fishing, keep fishing.
If weekends on the boat are your escape, keep boating.
If you enjoy hunting, golf, hiking, traveling, working in the yard, or spending time with your family, those things should remain part of your life.
The goal isn't to give them up.
The goal is to stay healthy enough to keep doing them.
You Don't Have to Become a Marathon Runner
One of the biggest misconceptions about getting healthier after 40 is that it requires a complete lifestyle transformation.
It doesn't.
You don't have to become a marathon runner.
You don't have to spend every morning in the gym.
You don't have to eat perfectly at every meal.
And you don't have to give up the activities that make life enjoyable.
What does become increasingly important is being intentional about a few things that were easier to ignore when you were younger:
Maintain your muscle.
Keep moving.
Know your blood pressure.
Pay attention to your cholesterol and metabolic health.
Watch what's happening around your waistline.
Prioritize sleep.
Maintain a healthy body composition.
And address medical or hormonal problems when they're actually present.
None of those things requires becoming a different person.
They're about helping you remain the person you already are.
Your Muscles Are an Investment in Your Future
This is one area where our understanding of healthy aging continues to evolve.
For years, many people thought of resistance training as something you did primarily to look muscular.
That's not how I look at it—especially after 40.
Skeletal muscle is an investment in your future.
As we age, we can progressively lose muscle mass, strength, and physical performance. When this age-related decline becomes clinically significant, it can contribute to sarcopenia.
And you don't want to wait until you're 70 or 80 to start thinking about maintaining muscle.
Your 40s, 50s, and 60s are an opportunity to preserve and build the physical reserve you'll want later in life.
Think about what strength actually allows you to do.
Pull an anchor.
Carry a cooler.
Load fishing gear.
Climb a boat ladder.
Walk a long dock carrying equipment.
Get up from the ground.
Lift your luggage.
Work around your house.
Play with your grandchildren.
Remain independent as you get older.
Those things have very little to do with looking good in a mirror.
They have everything to do with function.
New Resistance-Training Guidance: Consistency Matters More Than Complexity
In 2026, the American College of Sports Medicine published a major update to its resistance-training position stand—the first major update since 2009.
The updated position stand synthesized 137 systematic reviews involving more than 30,000 participants.
One of the most practical messages from the new guidance is remarkably simple:
Resistance training doesn't have to be complicated to be effective.
The biggest improvement often comes from going from no resistance training to doing some resistance training consistently. The evidence supports improvements in muscle strength, muscle size, power, endurance, and physical function.
The guidance emphasizes training all major muscle groups at least twice per week as a practical approach for healthy adults. It also emphasizes individualization—there isn't one perfect program that everyone needs to follow.
That doesn't necessarily require an elaborate gym.
Free weights can work.
Machines can work.
Resistance bands can work.
Body-weight exercises can work.
Home-based workouts can work.
The best program is ultimately the one that fits your life and that you're willing to continue.
You're not necessarily training for a competition.
You're training for the rest of your life.
Fishing and Boating Keep You Moving—But Don't Forget Strength
If you've ever spent an entire day fishing offshore, you already know it isn't necessarily a sedentary activity.
You're loading equipment.
Carrying tackle.
Launching the boat.
Moving around on an unstable surface.
Casting.
Reeling.
Handling fish.
Pulling anchors or lines.
Cleaning everything up afterward.
And sometimes doing all of it in the Florida heat.
Those activities keep you moving, and doing something you enjoy can be a great reason to stay active.
But recreational activity doesn't necessarily provide the progressive challenge to your muscles that structured resistance training can provide.
That's why I like the combination:
Keep doing the activities you love—and add resistance training to help preserve the strength that allows you to keep doing them.
You don't have to choose between an active lifestyle and strength training.
You can have both.
Pay Attention to the Things You Can't Feel
Strength is only one part of healthy aging.
The other part is what's happening inside your body.
One of the lessons I've learned during my career in cardiology is that feeling healthy and being free of cardiovascular risk aren't necessarily the same thing.
You generally can't feel your LDL cholesterol.
You may not feel elevated blood pressure.
You may not notice insulin resistance developing.
And increasing abdominal or visceral fat can occur gradually enough that it becomes your new normal.
Cardiovascular disease can develop over years before producing an obvious event or symptom.
That's why preventive care matters.
Don't look only at the number on the bathroom scale.
Know your numbers and understand what they mean in the context of your overall health.
Depending on your individual situation, that conversation may include:
Blood pressure
Cholesterol
Blood glucose and hemoglobin A1c
Waist circumference and body composition
Family history
Smoking history
Physical activity
Sleep
Kidney function
Other cardiovascular risk factors
In some patients, additional testing or more advanced lipid assessment may also be appropriate.
The important point is that no single number tells the entire story.
Health is the bigger picture.
What About Testosterone After 40?
Testosterone has become one of the most talked-about areas of men's health.
Unfortunately, it can also become oversimplified.
A man is tired.
His workouts aren't producing the same results.
He's gaining abdominal weight.
His libido isn't what it used to be.
He doesn't feel like himself.
And immediately the assumption becomes:
"My testosterone must be low."
Maybe.
But those symptoms can have many potential causes.
Sleep problems, obesity, medications, metabolic disease, psychological factors, other medical conditions, and lifestyle factors can sometimes produce similar complaints.
That's why appropriate evaluation matters.
Testosterone therapy shouldn't simply be about chasing a laboratory number or treating every symptom of aging with a hormone.
The clinical question is whether someone has symptoms consistent with testosterone deficiency together with appropriately confirmed low testosterone levels, followed by consideration of why those levels are low.
When testosterone deficiency is actually present, that's a different conversation.
Our Understanding of Testosterone and Cardiovascular Risk Has Changed
For years, one of the biggest concerns surrounding testosterone replacement therapy was whether treatment increased cardiovascular risk.
That concern led to substantial debate and changes in testosterone labeling.
Then came an important clinical trial.
The TRAVERSE trial, published in the New England Journal of Medicine in 2023, enrolled more than 5,200 men between 45 and 80 years old who had symptoms consistent with hypogonadism, repeatedly low testosterone concentrations, and either existing cardiovascular disease or elevated cardiovascular risk. Participants were randomly assigned to testosterone gel or placebo.
The primary cardiovascular endpoint examined major adverse cardiovascular events—a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
The primary endpoint occurred in:
7.0% of men receiving testosterone
versus
7.3% of men receiving placebo.
The primary cardiovascular outcome occurred in 7.0% of men receiving testosterone and 7.3% of men receiving placebo. The researchers concluded that testosterone therapy did not increase the risk of major cardiovascular events compared with placebo in the men studied.
That's an important finding.
But it's equally important to understand what it doesn't mean.
TRAVERSE did not prove that testosterone prevents heart attacks.
It did not establish testosterone as a treatment for cardiovascular disease.
It did not prove testosterone therapy is risk-free.
And it certainly didn't demonstrate that every middle-aged man should receive testosterone.
The trial provides reassurance about the primary cardiovascular outcome in the population studied when testosterone was prescribed for appropriately identified hypogonadism.
What About Atrial Fibrillation?
This is where the details of the TRAVERSE results matter.
The investigators reported a higher incidence of several individual adverse events in the testosterone group, including atrial fibrillation, acute kidney injury, and pulmonary embolism.
Atrial fibrillation occurred in:
3.5% of the testosterone group
versus
2.4% of the placebo group.
Atrial fibrillation was not the primary cardiovascular endpoint of TRAVERSE.
The primary endpoint was the composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke, and that endpoint met the trial's noninferiority criterion.
The TRAVERSE statistical analysis also did not include multiplicity adjustments for secondary and other endpoints, meaning those individual findings should not be interpreted as definitive evidence of a treatment effect on those outcomes.
In other words, the appropriate takeaway isn't:
"Testosterone causes atrial fibrillation."
Nor is it:
"There was no atrial fibrillation signal."
The accurate takeaway is that TRAVERSE found a higher incidence of atrial fibrillation among testosterone-treated participants, while its primary major cardiovascular endpoint did not demonstrate excess risk.
That's an important distinction when discussing the study with patients.
The FDA Changed the Testosterone Warning
The TRAVERSE findings contributed to an important regulatory change.
In February 2025, the U.S. Food and Drug Administration announced class-wide labeling changes for testosterone products.
After reviewing TRAVERSE and other evidence, the FDA removed language from the boxed warning concerning an increased risk of adverse cardiovascular outcomes for testosterone products.
But there was another part of the FDA announcement that is just as important.
The FDA also required labeling changes regarding increases in blood pressure with testosterone products.
The FDA explained that ambulatory blood-pressure monitoring studies involving different testosterone formulations and routes of administration raised concerns about blood-pressure increases. Subsequent postmarketing monitoring across testosterone products confirmed an increase in blood pressure class-wide.
That's a perfect example of why medical evidence rarely fits into a social-media headline.
The message isn't:
"Testosterone is dangerous."
And it isn't:
"Testosterone is completely safe."
The evidence is more nuanced.
For men with appropriately diagnosed testosterone deficiency, testosterone therapy can be considered after an individualized discussion of potential benefits, risks, contraindications, and appropriate monitoring.
That's what practicing evidence-based medicine looks like.
Healthy Aging Is Bigger Than Testosterone
This may be the most important part of this article.
No medication or hormone replaces the fundamentals.
If you want to remain active as you age, think about your entire health picture.
Build and maintain muscle.
Move regularly.
Control your blood pressure.
Address abnormal cholesterol.
Pay attention to blood sugar and metabolic health.
Prioritize sleep.
Maintain a healthy body composition.
Don't smoke.
Keep up with appropriate preventive care.
And when symptoms suggest an underlying medical or hormonal problem, get evaluated rather than guessing.
Testosterone may be appropriate for some men.
It isn't the answer to everything.
Your Goal Isn't Simply More Years—It's More Capable Years
When people talk about longevity, the conversation often focuses entirely on lifespan.
I think there's another question worth asking:
What do you want those years to look like?
Can you still climb into your boat?
Can you carry your own gear?
Can you walk the dock without getting winded?
Can you play 18 holes?
Can you travel?
Can you work around your house?
Can you get down on the floor with your grandchildren—and get back up?
Can you spend a day doing something you love without your physical abilities becoming the limiting factor?
That's where maintaining cardiovascular health, metabolic health, muscle, strength, and mobility all come together.
It's not about trying to stay 25 forever.
It's about maintaining your ability to live independently and do the things that give your life meaning.
You Don't Have to Stop Doing What You Love
Getting healthier after 40 doesn't mean becoming a different person.
Keep fishing.
Keep boating.
Keep golfing.
Keep hunting.
Keep traveling.
Keep getting outdoors.
Keep spending time with the people who matter to you.
But recognize that the body carrying you through those experiences needs some attention too.
Build and maintain muscle.
Protect your cardiovascular health.
Know your numbers.
Prioritize sleep.
Stay active.
Address medical problems when they're actually present.
And don't wait until you've lost your strength, mobility, or health to start protecting them.
Healthy aging isn't about giving up your life to become healthier.
It's about taking care of yourself so you can keep living the life you love.
Outlast the Day.
Jeff Schnur, MSN, APRN, FNP-BC
Clinical Director
Apex Coastal Wellness
References
Currier BS, D'Souza AC, Fiatarone Singh MA, et al. American College of Sports Medicine Position Stand: Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews. Medicine & Science in Sports & Exercise. 2026.
American College of Sports Medicine. ACSM Publishes Updated Resistance Training Guidelines. 2026.
Lincoff AM, Bhasin S, Flevaris P, et al.; TRAVERSE Study Investigators. Cardiovascular Safety of Testosterone-Replacement Therapy. New England Journal of Medicine. 2023;389:107–117.
U.S. Food and Drug Administration. FDA Issues Class-Wide Labeling Changes for Testosterone Products. February 28, 2025.
U.S. Food and Drug Administration. Testosterone Information. Updated 2026.
American College of Sports Medicine. 5 Things to Know About Creating an Effective Resistance Training Plan. 2026.
