The Best of Everything After 50

The Experts' Guide to Style, Sex, Health, Money, and More


By Barbara Hannah Grufferman

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The Best of Everything after 50 provides top-dollar advice in an affordable format. When Barbara Grufferman turned fifty, she wanted to know how to be — and stay — a vibrant woman after the half-century mark. She went in search of a “What to Expect” book, but couldn’t find one. So she consulted New York City’s leading doctors, personal trainers, hair stylists, fashion gurus, and financial planners including:

Diane Von Furstenberg on the right fashion choices
Laura Geller and Carmindy on makeup tips
Dr. Patricia Wexler on the best skin care regimen
Frederic Fekkai on haircare
Jane Bryant Quinn on financial concerns
Julie Morgenstern on organizing your life

Barbara adopted their programs and prescriptions, and got life-changing results — and now she shares her experiences. With a handy format and “checklist” style, The Best of Everything after 50 makes high-priced advice accessible to any woman interested in getting answers to the issues that concern her most.


To Howard, Sarah and Elizabeth
You are the best of everything

I wrote this book for me.
I was perfectly fine with turning fifty—except that it snuck up on me. Once I got over the shock and realized that I was really and truly going to be fifty, I wanted to do it right. While I really believe I'm getting better as I get older, I also know that my body and lifestyle have changed with the years and I haven't really paid attention to how those changes will affect me in the long-term. I needed a new plan for dealing with my new reality. I had questions about big things (How can I prevent heart disease?) and less frightening but still important ones (Can I still wear 7 For All Mankind jeans?).
Knowledge is power, right? So I went on a quest to find the answers. I searched the Internet, bookstores, and magazines, but it soon turned into information overload. Everybody had an opinion—and most of them conflicted with each other. Then one day, it hit me. I didn't want lots of information; I wanted the best information—bottom line—about what I needed to know now about my skin, hair, makeup, health, sex, clothes, exercise, money and more. Talking to my friends, it was clear we were all looking for the same thing—a simple guide to living well over fifty that would give us the answers we needed in a simple format.
I wanted a straightforward book that put all of the most useful information in one place with common sense but without fuss or too much jargon. "Tell me what I need to know and tell me now" is part of the collective consciousness of women over fifty. We want to streamline our lives down to the essential elements. I know, because I am this woman, too.
The book didn't exist, so I decided to write it myself.
I searched out the top experts in all of these fields—and more—and asked them my questions, put myself in their hands, did their programs (to make sure they really worked), and then shared everything I learned with all my women friends.
The result is this book.
It poses the questions, explains the research, introduces the experts, and offers answers, solutions, and advice. I've used myself as the test case to make sure that all of this advice is effective and I give real-life examples of what I do, and what other savvy women I know are doing—and tell you what is working for us.
At the end of every chapter there is a concise list of important findings that recaps the advice, and includes the essential "must-dos" and "must-haves." Every chapter also includes a list of other resources for more in-depth information. The book ends with the best of the best for women over fifty: "The Plan" which puts everything into a manageable outline.
The Best of Everything After 50 will be your go-to reference guide to our changing bodies and lifestyles. You'll find yourself picking it up whenever you have a question about health, your heart, skin care, makeup, style, money, sex, organizing your life, losing weight, getting in shape, and so much more. Your questions will be the same as mine, I guarantee.
I learned a great deal from my wonderful experts, but the most important lesson of all is this: if you're healthy, you feel good. If you feel good, you look good. If you feel good, look good, have your finances under control, and a vision for your future, you feel even better. If you've got all that plus the knowledge about how to stay that way (with some good sex thrown in), you feel amazing. And if you feel amazing, who cares about age?
That is what it means to have the best of everything.

Chapter 1
Feelin' Alright
Don't Worry, Be Healthy
I have an early childhood memory of counting backward from 100—and then waking up much later to the sing-song voice of my mother asking, "Would you like some ice cream?" While I was happy about the ice cream, I still don't know why my tonsils had to be removed. The little buggers had never given me any problems, and yet . . . out they came. To this day, even my mother isn't sure why. During the fifties and sixties, countless American children had their tonsils removed—it was practically a rite of passage. This is no longer the case. We know much more now than we did then, are more informed, and most of us have access to better health care. Questioning a doctor's opinion and seeking out a second one is more the norm. It can still be confusing, though, especially as we get older.


I entered my adult years with the same high expectations of good health that I had as a kid. Why not? I had taken my Flintstones vitamins every morning for years. I felt invincible and indestructible in my twenties and thirties—even my forties.

But what if . . . ?

After I crossed the threshold of fifty, I started to look around a little more. Some people my age were having strokes, contracting cancer, struggling with depression, gaining weight, and developing diabetes. It's not that people who were younger didn't have some of these health concerns. After fifty, it suddenly seemed all too common. I started asking myself the "what if" questions: What if I really get sick, or have a heart attack? Can I get Alzheimer's? What if I get cancer? Do I already have cancer and don't even know it?
The more I thought about it, the more questions I had: Can some of these illnesses be prevented? Am I doing everything right to protect myself? Am I at risk for something serious? How would I know? Are there tests I should be getting? What, where, and how often? I'm over fifty. What can I do to make sure that as I get older, I live a good, healthy life?

We can't control getting older. We can control how we do it.

I was determined to find out how we could age gracefully, with dignity and relatively good health. Like many other women, I had gone for a long time without doing simple things that could positively affect my health and well-being. Life had kept me busy taking care of others, but kept me from doing the right things for myself. Sleeping enough and exercising daily had seemed like an indulgence, even as I made sure my family was well-fed and well-rested. Was I too late to make a difference in my own health?

A Promise to Ourselves

Yes, we are going to get older. Let's control how we do it, so we can be productive, fit, and strong women, no matter what our age. There are measures we can take now that will help us to enjoy our later years, not just endure them. Starting today, starting now, make this our goal: everything we do, we will do in a way that will benefit us and our current—and future—selves. We will prioritize our quality of life, not compromise it. It's not exactly starting over, but starting on a new path. It's a thoughtful, mindful approach to healthy living. We can do it.
But how?

When in doubt, do more research, but try not to drive yourself crazy.

After giving myself weeks of night-mares by exhaustively researching each and every possible disease and illness and bodily malfunction that could hit a woman over fifty, I woke up one morning and thought: "Enough already." I was making myself crazy, nervous, and a hypochondriac. Not a good way to start on my new life plan. Instead of obsessing over unlikely scenarios and struggling with medical jargon, I needed to get real information about the most probable problems and, more importantly, the best defenses. I needed to call in the experts.
I scheduled my annual physical exam and asked my doctor for a double session so he could talk me through everything I really needed to know—and do—going forward.

It's time to take control.

Dr. Greg Pitaro has been my Primary Care Physician (PCP) for over ten years. He's checked my blood pressure and cholesterol levels, taken my temperature and made me say "aaaaah" when I've caught strep throat from my daughters, and has always made me feel empowered with information. When I saw Dr. Pitaro to talk about my concerns about being fifty he was patient, informative, clear, and right to the point.

It's not about preventing death. It's all about preventing preventable death.

Certain deaths are preventable. Every year an estimated 900,000 Americans die from preventable illnesses, and millions more are disabled by them. It doesn't have to be this way. Take care of your body and it will take care of you. Do the right things (eat well, exercise, don't smoke, keep a good weight, listen to your body) and you will be doing everything that is in your control to keep preventable illnesses and disease out of your life. Here's what he told me.
Top Ten Causes of Preventable Death
1. Smoking
2. High blood pressure
3. Obesity
4. Inadequate physical activity
5. High blood glucose level
6. High LDL cholesterol
7. High salt intake
8. Too low intake of omega-3 fatty acids (from seafood)
9. High levels of trans fat in the diet
10. Alcoholism and alcohol abuse

The Usual Suspects

You don't need to get crazy imagining exotic illnesses. The biggest dangers are exactly what you'd guess. The leading causes of death for American women over fifty are, in order: heart disease, cancer, stroke, lung disease, and Alzheimer's disease. Heart disease is responsible for about 30 percent of those deaths and cancer for another 20 percent. The good news is that heart disease and some cancers can be prevented, especially if you keep your blood pressure in check and don't smoke.
I asked Dr. Pitaro for a primer on the major threats that might get between us and our long-term health goals, starting with the number one cause. I also consulted with Dr. James Underberg, a specialist in heart disease prevention and lipidology who is a key expert in Chapter 2: Keep the Beat.

Cause No. 1: Heart Disease

Since heart disease and stroke are responsible for killing one-third of older women, the entire next chapter is devoted to heart health. But here are the basics.
Cardiovascular disease, or CVD, is a group of problems related to the breakdown or blockage of the heart or blood vessels. Blood delivers oxygen and energy cells that make up our bodies. If the heart can't pump blood, or if blood doesn't move efficiently through your veins and arteries, you can develop CVD.

How to Prevent CVD

Most heart disease is related to the build-up of fatty substances—plaque and cholesterol—on the walls of the arteries that carry blood. Most heart disease can be prevented by eating healthy foods, not smoking, getting regular exercise to keep your heart strong and your arteries free from build-up, and minimizing stress and anxiety, which can put strain on your heart.

Cause No. 2: Cancer

Are you thinking "Good grief, why is she doing this? I thought this was going to be a fun book about great hairstyles and good sex! She's starting to freak me out!" No, no, no. You just have to face a few facts and make yourself more aware, informed, and tuned into your body, and then we'll get to the fun stuff.

We will survive.

About one in three women will be diagnosed with some form of cancer in her lifetime, so we can't ignore it. The majority of us will survive. The overall five-year relative survival rate is as high as 97 percent for the most common forms of cancer, when it is caught and treated early. The best way to catch cancer in the act is to know what you're looking for.

What is cancer?

All cancers begin in cells in the body. Cells make up tissues, which make up the organs of the body. In a healthy body, cells grow and divide to form new cells as needed. When cells grow old and die, new cells take their place, but sometimes things go wrong. New cells form when the body does not need them, and old cells do not die when they are supposed to. The extra cells in the body form a mass of tissue—a tumor, which can be either benign (not cancerous) or malignant (cancerous). Sometimes tumors stay put, but they can spread out and run amok in our bodies (metastatic cancer). If cancer spreads and cannot be controlled, the cancerous cells interfere with the ability of healthy cells to function properly, and that's when the real trouble begins.

How common is cancer?

Cancer is the primary cause of 1 of every 4 deaths in the U.S. overall.
More than 1,437,200 new cancer cases were diagnosed in 2008.
There were about 565,000 cancer deaths in the U.S. in 2008.

Many cancers can be prevented.

About 5 percent of cancers are due to inherited gene mutations. Many of the other 95 percent can be avoided. Here are some recent facts from the American Cancer Society:
170,000 cancer deaths in 2008 were related to tobacco.
One third of all cancer deaths were directly related to obesity, physical inactivity, and poor nutrition.
Many of the more than 1,000,000 skin cancers diagnosed in 2008 could have been prevented by proper protection from the sun and avoiding indoor tanning.
Regular screening by health professionals can prevent some cancers, such as cancer of the cervix, colon, and rectum.
Screening tests may result in early detection and an increased cure rate of cancer of the breast, colon, rectum, cervix, skin, and oral cavity.
The best preventatives for most cancers are the same as for most of our other health concerns:
Avoid smoking.
Keep weight in check.
Get regular exercise.
Control diabetes.
Be aware of your family history.
Eat a lot of fresh fruits and vegetables and not too much fat.

What are the warning signs of cancer?

There are many kinds of cancers, but most cases occur in the same few places in the body: breasts, lungs, colon, uterus, lymph nodes, thyroid, and skin. Some cancers—like pancreatic cancer—develop with little warning and few well-known risks. There are regular screening tests that can help find a few cancers early which are covered later in this chapter and in Chapter 3: Changes Down Under. The sooner cancer is diagnosed, and the sooner treatment begins, the better the odds of survival. To give yourself the best chance of beating cancer, you need to rely on your own good sense and watch for signs, such as:
Chronic coughing or wheezing
Feeling short of breath
Vitamin D and Cancer Prevention
Vitamin D's importance in promoting bone health and reducing risk of osteoporosis is well established, but there's new evidence that the "sunshine vitamin" can reduce the risk of certain cancers and cardiovascular disease. Low vitamin D levels in the body (below 30 mg/ml) may predispose a woman to developing some cancers. Women over fifty should take in between 1,200 and 1,500 IU of vitamin D every day. To do this by diet alone would be impossible, so supplements are essential, in conjunction with eating foods that are good sources of vitamin D.
Coughing up blood or mucus with blood spots
Sudden, unexplained weight loss or weight gain
Difficulty swallowing
Pain or discomfort in the pelvic area or abdomen or a persistent stomachache
Feeling full but unable to eat
A pale or jaundiced complexion
Weakness and fatigue despite regular sleep
Repeated infections
Fever and night sweats
Bruising or bleeding easily, including frequent nosebleeds
Bone or joint pain
Swollen lymph nodes in the armpit, neck, or groin
Any persistent and inexplicable problem or pain
Vaginal spotting if you are post-menopausal
If you develop any of those symptoms—and especially if you develop two or more at the same time—report them to your doctor immediately. Keep in mind, many of these could be caused by problems other than cancer, so your doctor will conduct various tests (usually non-invasive ones, although biopsies may be necessary in some cases) to determine the cause and to help you decide on treatment.

Lung Cancer

Lung cancer is the #1 leading cause of cancer death for women. Although almost twice as many women are diagnosed with breast cancer compared to lung cancer, lung cancer deserves a special mention here because it kills many more of us. But it is avoidable.

What causes lung cancer?

Smoking. We are considered the smarter sex, and yet more women smoke than men. Lung cancer can also be caused by secondhand smoke or by toxins in the environment, but smoking is the biggest culprit. Once you quit, your lungs start to heal, stopping your risk from increasing.

I used to smoke.

During my discussion with Dr. Pitaro, I blurted out "I used to smoke!" Since I've been seeing him for over a decade, he already knew that. I suddenly needed to know if I should get a chest X-ray, a CT scan, anything and everything right then and there. He waited until I stopped hyperventilating (How could I have done that to myself? What about how my hair used to smell, and my breath, and my clothes? I started having terrible flashbacks of the little bits of tobacco that would be at the bottom of all my handbags . . .), and calmly explained how this would likely impact me. I started smoking when I was a teenager, and smoked on and off until my mid-thirties, never more than eight or so cigarettes a day. He said I was still considered low risk, because I hadn't smoked a pack or more a day, and I stopped almost twenty years ago. Relief. The statistical cancer risk didn't go down when I quit, but it isn't increasing either, because I no longer smoke. It just stopped where it was. What's more, our risk of developing cardiac disease lowers significantly after quitting (by over 50 percent starting the first year after you quit). Each year you don't smoke the risk gets lower. I'm breathing easier now.

What if you still smoke?

If you do, try your best to quit. You don't need to be told how dangerous it is to your health. Talk to your doctor about the best approach for you. Get a patch, get gum, get help, but you must quit—for your lungs, your heart, your skin, the people around you, your life.

Are there any screening tests for lung cancer?

There is no early test for lung cancer. There have been studies on the usefulness of chest X-rays, sputum cytologies, or CT Scans to screen for lung cancer in people who do not have symptoms, but so far the tests that doctors have now are only effective in confirming a diagnosis.

Cause No. 3: Emphysema

Lung disease is the fourth biggest cause of death in women in the U.S. While several chronic lower respiratory diseases, including asthma, are grouped together under the heading of lung disease, the most serious for people over fifty is emphysema. Emphysema used to be more common among men than women, but that is changing now that more women than men are smoking. It is usually caused by smoking or secondhand smoke, which makes emphysema, like lung cancer, a preventable disease.

What is emphysema?

Emphysema is a chronic, progressive lung disease in which the air sacs in the lungs are damaged severely enough to impair your ability to breathe and absorb oxygen. Because it develops gradually, it often goes undetected until it is quite advanced and is usually diagnosed in people between fifty and sixty years of age. Symptoms include:
Shortness of breath
Fatigue and tiring easily during physical activity
Chronic, mild cough
Loss of appetite and weight loss

How is emphysema diagnosed?

Since many of the symptoms of emphysema are similar to other lung diseases—including lung cancer—your doctor will perform a full physical exam and will also take a chest X-ray and conduct certain tests to measure your lung capacity and function and the amount of oxygen in your blood.

Cause No. 4: Alzheimer's Disease

I admit it. I forget things. Is this a sign that I'm getting Alzheimer's disease, or is it just normal, age-related memory loss? Our brains do slow down a bit as we age, but severe memory loss and seriously impaired reasoning skills are not "just part of aging" and should be addressed. Some Alzheimer's-like symptoms can be caused by treatable conditions like vitamin deficiencies, depression, thyroid problems, or excessive alcohol consumption.

What is Alzheimer's disease?

Alzheimer's disease is an irreversible and progressive brain disease that destroys brain cells, causing severe problems with memory, thinking, and behavior, and is the most common form of dementia. It ultimately leads to death. It can occur at almost any age, but is more likely once you're over sixty-five. Alzheimer's currently has no cure—but some symptoms can be treated and managed, especially in the early stages. Here are a few basic facts we should know:
One out of eight people age sixty-five or older has Alzheimer's.
That number doubles for every five-year age interval beyond age sixty-five.
5.3 million people have Alzheimer's in the U.S.
Alzheimer's is the seventh leading cause of death for older adults, but the fourth for women.

How is Alzheimer's diagnosed?

Because of the nature of Alzheimer's disease, the person may not know she has it. Diagnosis can be difficult, so a specialist is often required if family members or a PCP suspects Alzheimer's. There are a few tests (MRI, blood tests) that can be done to see if what's happening could be the onset of Alzheimer's—the earlier it is diagnosed, the better it can be managed.

Can Alzheimer's be prevented?

There is so much we don't know about Alzheimer's—including what causes it—but it seems to share some risks with more routine types of memory loss. Recommendations to both improve mental function and guard against Alzheimer's include:
Exercise your body.
Exercise your brain: tackle cross word puzzles or Sudoku, learn a new language, knit a complicated pattern, have new experiences—anything to challenge your mind.
Keep your blood pressure down.
Don't smoke.
Eat lots of fruits and vegetables.
Keep a positive attitude and enjoy life—if we stay alert and engaged, we automatically keep our brains active.
Have a busy social calendar—the more engaged we are socially, the healthier we remain.

Quality of Life

We've covered the major causes of death, but what about diseases that affect quality of life? Heart disease, stroke, cancer (specifically lung, breast, and certain gynecological cancers), emphysema, and Alzheimer's disease are statistically the most deadly for women over fifty—and the threat from all of them can be reduced by the choices that we make—but there are a few diseases that put a big damper on our quality of life.

Arthritis? Already?

My hair is naturally wavy. I usually scrunch it up a bit and leave it to air dry (see Chapter 9: No More Bad Hair Days). Recently, I scrunched it so hard that my middle finger began to hurt. The pain lasted over a week. Convinced I had broken my finger in the name of beauty, I made an appointment with a hand surgeon who had once treated me for carpal tunnel syndrome. The X-ray showed a little bursitis that the doctor said would go away eventually. Then he casually said, "Oh, by the way, you have some arthritis in your thumb." What? Only a few things have made me feel old since I turned fifty. This was one of them. Arthritis? Me? I couldn't believe it. My grandmother had arthritis, and I remember how she suffered with it. But hadn't she been way older than fifty? "Look at the X-ray again," I told him. "You must be mistaken." It turns out you can get osteoarthritis (the most common form of arthritis) at any age, but once you are over fifty, the chances of getting it somewhere in your body increase dramatically. It's also more common for women than men. And, yes, when the doctor checked the X-ray again, there it was.

What is arthritis?


  •, 4/1/10
    “…there isn’t one page in this book that you can afford to miss.”, 4/6/10
    "Barbara Hannah Grufferman created this go-to reference…each part helps set you on the right path, and doesn’t waste time in getting to the point. That’s one of the beauties of the book: no wasted words. It’s all about practical tips for style, make-up, sex, health, finance, and myriad other topics, and as it’s written by and for women over 50, it all makes sense.”, 4/8/10
    The Best of Everything After 50, a handy tome to help fine-tune your heart, head, health, hair and more ..."

    National Association of Baby Boomer Women, 5/27/10

    “Just over 300 pages, THE BEST OF EVERYTHING AFTER 50 contains, Grufferman says, everything you need to know to be the best you can be. But just in case her manual misses one of your top questions, each chapter ends with a handy list of websites you can reference to get more information. I'd call this a ‘must read!’”, 5/11/10
    "After-50 Operating Instructions . . . a manual for getting through this decade with ease, grace, forethought and, of course, style."

On Sale
Mar 30, 2010
Page Count
320 pages
Running Press

Barbara Hannah Grufferman

About the Author

Barbara Hannah Grufferman worked for many years in magazine publishing, started the magazine Teen Age, and was named “Publishing Star on the Rise” by Advertising Age. The Best of Everything After 50 is the result of Barbara’s mission to provide all women with the very best expert advice that New York has to offer. She lives in Manhattan.

Learn more about this author