Friday Q&A: vitamin D and anti-aging; health advice for men; how to get more dietary protein; & pelvic organ prolapse

You ask the best questions!

ICYMI 👉

• Understanding Prostate Cancer in Light of President Biden's Diagnosis

• When Do Normal Emotions Become Medical Problems?

• Brain Health: Practical Strategies for Cognitive Wellbeing

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I’m taking this afternoon off. So, I’ll see you Friday 5/30 for our next live Q&A!

MARK YOUR CALENDAR for a live conversation with primary care doctor and health communicator extraordinaire,

Adam Cifu, MD

— Tuesday 6/3 at 5 pm ET right here. We’ll discuss who to trust in medicine and public health, and what’s the deal with the FDA’s new COVID vaccine guidance. 💊

Starting next week, all subscribers will be able write me questions in REAL TIME to answer live. As always, paid subscribers can submit their questions for me to answer right here!

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In this week’s reader-submitted Q&A, we’re tackling these questions:

• What’s the buzz about vitamin D, telomeres and anti-aging?

• What health screenings and habits should men focus on?

• Are there easy ways to eat more protein throughout the day?

• What is pelvic organ prolapse and how can I manage it?

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📣 Send me your questions for future Q&As! Click here to write me. ✍️

Photo by Hannah Mn on Unsplash

The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: VITAMIN D & ANTI-AGING

CNN ran a piece this week about the positive effects of vitamin D supplements on DNA - reducing the risk of age related diseases. Is vitamin D something we should all be taking? How much does a person like me (healthy, 72, in good shape) need? I thought vitamin D was for my bones - but I also get a lot of sun so my doctor said don’t bother taking extra. Thanks - Eileen

Dear Eileen,

You are correct. A study published this week in the American Journal of Clinical Nutrition suggests that vitamin D supplementation may help reduce the shortening of telomeres, the protective ends of chromosomes which shorten over time and are associated with aging and disease. The study is compelling because it is the first large, randomized, placebo-controlled study on vitamin D and telomere length. But before you rush out to purchase vitamin D, know that a lot more study is needed to prove cause and effect.

Vitamin D had its heyday about 10 years ago when it was hypothesized to help with everything from breast cancer prevention and cardiovascular disease to depression and weight loss. However, a systematic review of data from nearly 250 studies published between 2009 and 2013 concluded that no relationship could be firmly established between vitamin D and health outcomes other than bone health.

Vitamin D helps the body absorb calcium, which is essential for maintaining strong bones and teeth. A deficiency can lead to conditions like rickets in children and osteoporosis in adults. (My piece about bone health is here.)

Vitamin D levels are measured in ng/ML and here are some goalposts:

• Vitamin D deficiency = Less than 20 ng/mL

• Insufficient vitamin D: 20–29 ng/mL

• Optimal vitamin D: 30–50 ng/mL

• Possible Upper Limit: 50–100 ng/mL (generally safe but avoid going above 100 ng/mL)

For anyone with osteopenia or osteoporosis, it’s best to aim for the higher end of the optimal range (30–50 ng/mL) to support bone health, but 30–40 ng/mL is often sufficient for most people.

Vitamin D may also play a role in supporting the immune system, helping the body fend off infections and diseases. Some studies suggest that vitamin D may help improve mood and reduce the risk of depression. It supports muscle strength and function, which is particularly important as we age. It would be great if vitamin D were found to play a significant role in slowing the aging process and reducing the risk of certain chronic diseases, including heart disease and some cancers, but for now, think of vitamin D as a bone vitamin above all else.

QUESTION #2: HEALTH ADVICE FOR MEN

I feel like all the health advice is geared toward women these days. Are there any particular health screenings or habits men should focus on more as we get older that aren’t getting enough attention?

- Mike

Mike,

I hear you—and you’re not wrong. There’s been a (much-needed) surge in attention to women’s health recently, but that doesn’t mean men don’t have unique and overlooked health needs, too—especially in midlife.

Here’s the truth: men are statistically less likely than women to go to the doctor, more likely to die of preventable diseases, and often socialized to “tough it out” instead of tuning in. So simply showing up, asking questions, and being curious about your health puts you ahead of the curve.

Some areas that often fly under the radar for men:

• Cardiovascular health: Heart disease remains the leading cause of death in men. Know your blood pressure, cholesterol, and glucose levels—and talk to your doctor about your individual risk factors, including family history.

• Mental health: Depression and anxiety in men can show up as irritability, fatigue, or substance use—often masked by a “keep it together” mindset. Let’s normalize tuning in emotionally just as much as physically.

• Prostate and sexual health: While routine PSA screening isn’t for everyone, it can be helpful for men at higher risk. (I wrote about President Biden’s cancer diagnosis here.) If you're noticing changes in urination, libido, or performance, don't write it off as “just getting older.” These are valid concerns and are often very treatable.

• Colorectal cancer screening: If you’re 45 or older, it’s time to start—especially since many early-stage colon cancers are asymptomatic.

• Bone health: Osteoporosis is not just a women’s issue. Men can experience bone loss, especially if they’ve been sedentary, had prolonged steroid use, or have low testosterone.

• Metabolic health: Midlife weight gain, high blood sugar, and creeping fatigue aren’t just annoyances—they’re clues. Prioritizing sleep, movement, strength training, and a fiber-rich diet is not vanity—it’s longevity.

The bottom line? Your health deserves attention. Preventive care isn’t about fear—it’s about staying strong and engaged in the life you want to live. I’m glad you asked!

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QUESTION #3: HOW TO GET MORE PROTEIN

I’m trying to eat more protein but I’m overwhelmed by the numbers and grams and math. Your friend Mary Claire Haver’s recommended daily protein means I would have to eat protein all day long!! Is there an easy way to do this without feeling like I’m meal-prepping for a bodybuilding competition?

- Lilly

Lilly,

I hear you—and I promise, you’re not alone. Between macros, grams-per-kilogram, and all the reels about cottage cheese and chicken breast, eating more protein can start to feel like a part-time job. But it doesn’t have to.

First, a little context: Protein is essential, especially as we age. It supports muscle mass, metabolism, satiety, and bone health. Mary Claire Haver and others recommend aiming for around 100 grams per day for many midlife women—not as a rigid rule, but as a general target that supports healthy aging.

But here’s the deal: You don’t have to hit that number perfectly—or overhaul your life to get there.

A few simple strategies I share with patients:

• Think of it as “protein with every meal and snack.” Eggs at breakfast, Greek yogurt or a protein shake mid-morning, some kind of lean protein at lunch (tuna, turkey, lentils, tofu), nuts or cheese in the afternoon, and fish, beans, or chicken with dinner.

• Sneak it in with snacks. Hard-boiled eggs, edamame, roasted chickpeas, string cheese, cottage cheese (I know, I know), or even jerky—these can easily add up.

• Don’t stress the math. If you’re getting some protein at each meal and snack, you’re likely doing far better than you think. Perfection is not the goal—consistency is.

And remember, protein isn’t just about body composition or satiety. It’s a pillar of metabolic health, especially in midlife. But so is joy, pleasure, and not feeling like every meal is a spreadsheet.

So no, you don’t need to live like a bodybuilder. Just aim to build meals around real, satisfying food—and give yourself some grace along the way. Note that Dr. Haver will join me on my live podcast on Friday June 6, so you can ask her for more details then!

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QUESTION #4: PELVIC ORGAN PROLAPSE

Thank you for your excellent essays and conversations. Sharon Malone was great! Here's a topic that we never hear anyone talk about: Pelvic Organ Prolapse. JAMA reports it is very common! (41% of women 51-79 will have some form of pelvic floor disorder and that it reaches 50% at age 80). Most women have never heard the word "prolapse." It seems like a really important topic to demystify, and not just for older women, but for middle aged healthy athletic women, too! Thank you!

- Carrie

Carrie,

You’re absolutely right—pelvic organ prolapse (POP) is incredibly common, widely misunderstood, and too often cloaked in silence or shame. And thank you for bringing it up—because this is exactly the kind of under-discussed health issue that needs sunlight, not stigma. Dr. Mary Claire Haver is joining me on my live podcast on Friday June 6, and we will be sure to discuss this then.

Pelvic organ prolapse happens when the muscles and tissues that support the pelvic organs—bladder, uterus, rectum—become weakened or stretched, allowing one or more of those organs to descend into or even outside the vaginal canal. The causes? Aging, hormonal shifts (especially the drop in estrogen during menopause), childbirth, chronic straining (think constipation), heavy lifting, and yes—even high-impact athletic activity.

Here’s the thing: prolapse isn’t a niche issue. It’s a public health issue hiding in plain sight. As you noted, up to half of women over 50 have some degree of pelvic floor dysfunction—and yet most have never been told the language to describe it, let alone offered support or solutions.

Symptoms vary widely:

• A feeling of “heaviness” or pressure in the pelvis

• A visible or palpable bulge in or near the vagina

• Urinary leakage or retention

• Trouble with bowel movements

• Pain during sex—or the avoidance of sex altogether

And yet, many women chalk these symptoms up to “just getting older,” not realizing there are evidence-based treatments that range from pelvic floor physical therapy to pessaries to surgery—depending on severity and personal preference.

So yes, let’s name it. Let’s normalize it. Let’s include it in conversations about menopause, aging, and sexual health—because demystifying prolapse is part of empowering women to understand their bodies, reclaim agency, and get the care they deserve.

Thank you for raising your voice. Let’s keep talking!

Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.

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ICYMI, check out my recent Q&As on:

• When to stop HRT; vaginal estrogen for UTIs; testosterone for men; & when to get a colonoscopy

• Ozempic & emotional eating; HRT for bone health; depression meds; & bladder pressure

• Low blood pressure; high fasting blood sugar; transitioning off GLP1s; & improving sleep