Energy dips, gray hairs and hope: What 36 looks like now
A study recently published in the Annals of Medicine adds some scientific evidence to back up those feelings. According to the 30-year study, which assessed both physical and mental health, age 36 is when many of the choices we made as younger people begin showing up in our bodies and minds. People who smoke or drink heavily, eat poorly or put off exercise often begin seeing significant health repercussions by the time they hit 36. Essentially, age 36 is a turning point for the process of aging.
This news made us think about what it really means to be 36 — both physically and emotionally — and how 36-year-olds think about themselves at this stage of life. (And, OK, what face cream are they using?) Here's what seven women told us.
Around the ages of 33 to 35, I became aware of changes to my body and face. I started noticing new lines on my face. Then a couple of months ago, I woke up one morning, and my arms just felt different. You hear people talk about losing muscle mass as you approach 40, and I have not been consistent about getting movement in. I do take long walks, and I'm now trying to be more consistent with lifting weights.
In terms of other self-care stuff, I dry brush my body, apply facial oil and do gua sha. Sunscreen is a must, and I'm seeking out clean brands and swapping products accordingly. I apply retinol to my face, neck and backs of my hands about one to two times a week. I also journal and am incorporating more meditation. I don't plan to get Botox, so I actively avoid smoking, drinking, tanning and any other vices that I hear contribute to aging.
I'm grateful for the freedom my journey to 36 has brought. I'm self-employed, divorced and on the brink of a dream move abroad. I'm not a mother, but I'm a proud auntie. Sometimes, I feel old and like so much life has passed. Other times, I feel like my life is only just beginning.
The age when I saw the most physical changes to my body was 34, right after I had my daughter. My body changed, and silver strands appeared in my hair. Now at 36, I have extra weight around my midsection, but I'm trying to give myself grace while also focusing on strength training. Professionally, I run my own podcast, and entrepreneur-and-toddler life is a workout all its own.
As for other ways I take care of myself, for the last 20 years I've sworn by the Clinique 3-step skin care system: cleanser, clarifying lotion and Dramatically Different moisturizer, morning and night. I don't smoke or tan, and I only drink on special occasions, usually a single glass of wine or champagne when celebrating.
Looking back at photos from my 20s shows me just how drastically my other priorities in life have shifted. Being 36 means motherhood first and work second. It means I'm building a life that fits my family, not squeezing my family into my life around my work.
As a longtime wellness enthusiast and former beauty editor, my self-care and beauty routines were very involved. More recently, they've become more intentional and health-conscious. As a new mom, self-care feels like taking the time to get a thorough massage after a few intense workouts, strength training so I can feel stronger, getting a professional blowout and investing in biweekly mani-pedis. It also looks like eating nourishing meals coupled with supplements to make sure I'm giving my body what it needs.
My beauty routine has shifted to double-cleansing my face, especially on days when I wear a face full of makeup. I also consistently exfoliate and rotate serums and eye creams for firming and brightness. I also always moisturize and use sunscreen.
In terms of cosmetic treatments, I got a little under-eye filler a few years back to treat under-eye bags—but it may be time for a refill. Thirty-six is definitely the age when I've noticed the most change. I'm starting to see changes in my face — it's not as firm and tight — and I'm the heaviest I've ever been. My hair has also grown its longest but sheds more than ever before. These things don't necessarily bother me, but I've noticed them all the most at 36.
For me, being well-fed and rested are the secrets to youthfulness. I tend to be obsessive about getting at least eight hours of sleep. Likewise, if I don't eat 'clean' I can absolutely feel the reverberations of that soon after. It's no longer worth it to me to feel bad in ways that I can control.
That said, I still drink some alcohol. I wish I could give up my wine on the weekends for the sake of my health, but I'm not emotionally ready for that yet.
My early 30s were the most dramatic shift in my physical appearance. It was like pressing a button, and my metabolism shut down. I now have to work very hard to stay fit, but on the flip side, if I work too hard, it's counterproductive to my body and produces a lot of stress.
Thirty-six feels like a big change physically too because I had a baby (unexpected C-section) at 35-and- a-half, and just about everything is now different physically. Since then, my hair has grayed significantly, every bit of my torso has morphed and my energy levels are currently nonexistent. But as I step into my late 30s, I feel newly invigorated to grasp on to youthfulness. Not in a desperate or aesthetic way, but rather to find the energy to keep doing all the things I love.
Thirty-six is a transformative year. For many of us, careers are more stable, we've got a kid or two — in my case, two little ones — and we're starting to think about what the next 36 years should look like. Social media makes aging feel like something to fight, not embrace. It pushes this idea that you have to do everything to avoid looking your age, and most of it is fake and insanely expensive.
My self-care routine is pretty simple. I don't do fancy facials or regular nail appointments, and my go-to moisturizer is an $8 tube of Vanicream (holy grail status). I started Botox at 26 — just 15 units in my forehead and crow's feet, maybe once or twice a year if I'm lucky. I never skip washing my face at night, and I slather on a Korean skin care product before bed, especially on my neck.
I'll also admit to the occasional spray tan. In my teens, though, I spent way too many hours in tanning beds, especially during visits to my grandma in Florida. If the sun wasn't out, she'd take us to the tanning salon so we'd come home glowing.
Looking toward the future, I've thought about plastic surgery but not for another eight to 10 years. I believe small tweaks can help slow the aging process. A full facelift isn't for me, but a few minor procedures might be on the table as I get closer to 50.
My mother and I were mistaken for sisters until I was about 25. Both my parents look far younger than their ages, and people have commented on that for years. I never thought much of that until I enjoyed receiving the same compliment. When I tell people I was born in 1988, they have genuine disbelief in their faces.
I have made my mistakes, however. In 2017, when the social media influencer was at its peak of power, I was convinced to start getting Botox in my forehead and 11s, and Juvéderm filler in my lips. I stopped getting the injections about two years ago simply because I wanted to go a more nontoxic route.
In my 20s I'd fall for every skin care trend and was weirdly proud of how many 'steps' my routine 'required.' A few years ago, a company reached out to me and paid me to review one of their skin care products. The product contained a topical steroid and caused me to break out in a horrific case of perioral dermatitis. I had to stop using literally everything … I couldn't even wear makeup for several months. After ruining my skin barrier, I started rebuilding my routine, which now consists of sensitive skin Dove bar soap (an oldie but a goodie) and the Amperna Soothing Duo. My confidence tanked when I had those breakouts, and I'd do anything not to feel so hopeless again.
Years 33 to 36 have brought on the most changes physically for me. My body takes longer to recover from workouts and alcohol consumption (I now feel the effects of two drinks the next day), and I need more sleep in general.
Since turning 36, I've become more conscious of how the choices I make will impact my future. I want to keep my mind sharp and my body physically active. My husband and I are considering starting a family in the next year, so I think a lot about what my body will need to carry a baby, my body/mental health postpartum and how to keep up with a toddler when I'm in my 40s.
Right now, I work out three to four times per week, eat well and take a variety of daily supplements. I drink about three times per week and use a nicotine vape daily.
The one vanity piece that bothers me is my gray hair. My dad was almost completely gray by 40, and I definitely got his genes. One day I will proudly rock it, but I'm not ready to yet.
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The healthiest types of yogurt (and the pots full of sugar)
Yogurt gets the green light when it comes to our health. It's full of calcium to maintain our bone health, which is especially important as we age and the reason why its cited by centenarians as the food that helped them reach 100. One study linked greater yogurt consumption with higher bone density, suggesting it can protect against fractures. It's also famously good for our gut health as it's full to the brim of bacteria that feeds our microbes. Recent research suggests it's even better than originally realised and can lower the risk of cancer taking hold in our bowel. The caveat is that the type of yogurt we eat really matters. At its simplest, yogurt is milk that has been pasteurised – meaning it's heated to kill 'bad' bacteria. 'Good' bacteria (usually Lactobacillus bulgaricus and Streptococcus thermophilus) is then added and the liquid is left to ferment and thicken. But the journey often doesn't end there. Flavourings, emulsifiers, sweeteners and sugar are injected to enhance taste and texture – even in those with 'health halo' branding. Why we should eat more yogurt Rich in calcium for bone health Contains minerals that protect heart health Source of protein to support muscle mass Full of bacteria to support gut health Lowers bowel cancer risk Yogurt is a nutrient-dense food that supports health, from your muscles and bones to gut and heart. Famously, it's a good source of calcium, providing around 120mg per 100g (15 per cent of the daily recommended intake for adults), as well as around 50mcg of iodine (a third of daily intake). 'These minerals support bone and teeth health, as well as thyroid function and metabolism,' Nichola Ludlam-Raine, a registered dietitian and author of How Not to Eat Ultra-Processed notes. Research also suggests that the calcium, magnesium and potassium in yogurt may support heart health, as these minerals help to regulate blood pressure. Yogurt can also be a good source of protein, containing up to 13g per 100g, though it's important to check the label as some contain less than 1g. 'Protein helps with muscle maintenance and satiety,' Ludlam-Raine says. It's especially important to consume enough protein as we get older, to reduce the decline in muscle mass that comes with age. 'Yogurt also contains beneficial bacteria (especially if labelled as 'live' or fermented) which can support gut health,' she notes. Even more impressively, eating two or more servings per week seems to protect against bowel cancer, possibly because the probiotics it contains encourages a wider array of beneficial bugs to live in our gut, which has a knock-on effect of less inflammation and fewer cancer-causing chemicals, scientists believe. 'As with other sources of dairy, it is also rich in B vitamins, especially B12 and riboflavin (B2) which are important for energy metabolism and brain function,' Ludlam-Raine says. How much yogurt should we eat? When it comes to how much to eat, 120g to 150g is the recommended portion, which is around one small pot or a few heaped teaspoons. 'It's perfectly fine, and often beneficial, to eat yogurt daily, especially if you choose plain, unsweetened, live-culture varieties,' Ludlam-Raine says. 'For gut health, regular, consistent intake (three to seven times per week) is more effective than just having it occasionally.' The best types of yogurt to buy – and the ones to avoid I compiled the nutritional data for around 200 different yogurts and asked Ludlam-Raine to choose the healthiest and least healthy, from the big brands to supermarket own label. 'The healthiest and least healthy yogurts were identified by reviewing several key nutritional markers per 100g: sugar content, calories, saturated fat and protein,' she says. 'Sugar was a primary factor, particularly in flavoured and dessert-style yogurts where added sugars can be high, often tipping the balance from snack to 'treat'.' She also considered saturated fat, which when consumed in excess can impact heart health, as well as protein content, which can support satiety and muscle maintenance. 'Gut health products were reviewed with reference to live bacterial cultures (probiotics) and prebiotic fibres, where listed,' she explains. 'I prioritised options that provided a variety of strains and where there is clinical backing. 'Ultimately, choices were made with a holistic lens, balancing nutritional composition, functional benefits, and real-world suitability for people looking to support their health through yogurt products.' 1. Flavoured yogurt 'These are more dessert than yogurt – often high in added sugar, fat and artificial ingredients,' Ludlam-Raine notes. While they are fine as an occasional treat, they shouldn't be mistaken as a healthy yogurt that we should be consuming daily to benefit our health, she explains. Healthiest: M&S Luxury Strawberries & Cream Yogurt 'This is a relatively lighter option,' she says. 'It has 119 calories per 100g – on the lower end for this category – with 10g of sugar and 2.9g of protein, making it a more balanced treat. It also contains less saturated fat (4.3g) compared to many others.' Least healthy: M&S Luxury Lemon & Lime Curd Yogurt 'On the other hand, M&S Luxury Lemon & Lime Curd Yogurt is the least healthy choice,' Ludlam-Raine says. It's the highest in calories (169), saturated fat (5.2g) and sugar (20.4g), containing the equivalent of five teaspoons per 100g. 'Making it more of a dessert than a nutritious snack,' she adds. 'This is best enjoyed occasionally rather than as part of a daily diet.' 2. Low-fat yogurt Low-fat yogurt may sound like a healthy option, as we know that too much fat will do our health no favours. 'However, flavoured varieties are often higher in added sugars or artificial sweeteners to boost flavour,' Ludlam-Raine notes. Removing fat also reduces the vitamin A, D, E and K found in yogurt. As a result, natural low-fat yogurt is not necessarily healthier than higher fat options, as fat also helps with nutrient absorption and satiety, meaning it keeps us fuller for longer. Healthiest: Sainsbury's Fat Free Natural Yogurt 'This yogurt is low in calories and fat, yet still provides a solid 5g of protein per 100g, making it filling and supportive of muscle maintenance,' Ludlam-Raine says. 'While the sugar content sits at 6.4g, this is likely to be naturally occurring lactose, not added sugar, as it's a plain fat-free yogurt.' 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'Greek yogurt is strained making it naturally creamy, but Greek-style is not strained and often thickened with cream or thickeners to mimic texture,' Ludlam-Raine explains. 'It can still be nutritious but may contain more fat and additives.' The key thing to look for is a lower calorie and fat content, while 'live' options will offer more gut-friendly bacteria. Healthiest: M&S Greek Style Live Yogurt 0% Fat 'This yogurt is low in calories (56 per 100g), fat (0.4g) and saturated fat, with a moderate sugar content and no additives,' Ludlam-Raine says. 'It also contains live cultures, which are beneficial for gut health.' It has one of the highest protein contents out of the 18 Greek-style yogurts included in the analysis (8.3g per 100g), which will help with muscle maintenance, fullness and satiety, she notes. 'Overall, it's a great everyday option – especially for those watching their fat or calorie intake.' Least healthy: M&S Greek Style Live Yogurt Conversely, the full-fat version of the M&S Greek Style live yogurt is the least healthy option, according to Ludlam-Raine. 'This version is significantly higher in calories (124) and saturated fat (6.5g), yet offers less than half the protein of the 0 per cent fat version (4.1g),' she explains. 'While the sugar content is the same, the overall balance is poorer – more fat and less filling, making it a less optimal choice for regular consumption.' 4. High protein yogurt The trend towards protein-rich food means that many yogurts now have 'high protein' on the packaging. 'These are often fortified with extra milk protein and great for muscle repair, satiety or post-exercise recovery,' Ludlam-Raine explains. However, it's important to read the labels to avoid regularly consuming those with added sugars and artificial sweeteners, she says. 'Choose plain if you can and sweeten it at home, or enjoy it instead of a sugary dessert,' she suggests. Healthiest: Biotiful Gut Health Kefir Protein Original 'This product is a standout for its combination of high protein content (12g per 100g) and low sugar (3.5g), fat (0.4g) and calories (66),' Ludlam-Raine says. 'It also offers the added benefit of live cultures from kefir, supporting both muscle maintenance and gut health. It's a great all-rounder for anyone looking to increase protein intake without added sugar or unnecessary fat.' Least healthy: The Coconut Collab Protein Yog 'Despite being branded as a 'protein' yogurt, this option is relatively low in protein (albeit good for a non-dairy brand),' Ludlam-Raine notes. It has just 5.9g per 100g, which is less than some standard yogurts that are not advertised as high in protein. It is also the highest calorie protein yogurt (135 calories per 100g). 'It is very high in fat, especially saturated fat (6g), due to its coconut base,' Ludlam-Raine notes. While it suits dairy-free and plant-based diets, this yogurt doesn't deliver on its protein promise, she says. 5. Greek yoghurt Greek yogurt differs from natural yogurt because there is an extra step in how it is made. It is strained, which removes a lot of liquid, resulting in a thicker form of yogurt. 'Greek yogurt is higher in protein and lower in lactose than regular yogurt, making it filling and great for blood sugar balance,' Ludlam-Raine notes. Plain, unsweetened versions are the healthiest option, she says. Healthiest: Fage Total 5% Fat Natural Greek Yogurt This is the healthiest Greek yogurt, thanks to its balanced nutrition profile, moderate calories (93), healthy fats (5g), lower sugar content (3g) and high protein (9g), according to Ludlam-Raine. It also has the lowest salt content (0.1g). 'It offers all the benefits of Greek yogurt without being excessively rich or processed,' she says. Least healthy: Waitrose No. 1 Strained Natural Greek Yogurt The Waitrose Greek yogurt is the least healthy option, Ludlam-Raine says. 'It has one of the the highest calories (131) and fat (9.9g), with 6.7g saturated fat and only 5.9g protein per 100g,' she notes. 'That said, Greek yogurt in general is a much healthier option than many dessert-style or heavily sweetened yogurts.' 6. Natural yogurt Plain, natural yogurt is one of the purest forms of yogurt. 'It's minimally processed, with no added sugars, and provides a natural source of protein, calcium and live cultures,' Ludlam-Raine notes. As well as being tasty on its own, it's very versatile and a great base for sweet or savoury dishes, she adds. Healthiest: Arla Skyr Natural Icelandic Style Yogurt Skyr is technically an Icelandic-style strained yogurt but it sits within the natural yogurt category due to its minimal processing, Ludlam-Raine says. 'This yogurt is the clear winner thanks to its low fat (less than 0.5g), saturated fat (less than 0.1g) and sugar (4g) content, while packing in an impressive 10.6g of protein per 100g,' Ludlam-Raine says. 'It's perfect for satiety, muscle repair and overall nutrition, especially if you're looking for a high-protein, low-fat option. Least healthy: Sainsbury's Natural Yogurt 'This version is higher in fat (3.8g), saturated fat (2.5g), and sugar (6.6g) than most others in the category, yet provides only moderate protein (5.1g),' Ludlam-Raine explains. 'It's not unhealthy per se, but when compared with leaner, higher-protein alternatives like Skyr or 0% fat yogurts, it's less balanced for everyday use, particularly if you're aiming to manage weight, blood sugar or heart health.' Despite this, opting for any natural yogurt will be a healthy choice compared to sweetened or dessert-style yogurts, she notes. 7. Yogurt shots Marketed for gut health, yogurt shots contain live cultures and can be a helpful addition if you struggle with digestion, but are not a substitute for a balanced diet as they don't provide enough fibre. Choose plain varieties for reduced added sugar. Healthiest: M&S x ZOE Gut Shot 'The M&S x ZOE Gut Shot stands out as the healthiest yogurt shot in this category, with a balanced nutritional profile,' Ludlam-Raine says. It's low in sugar (5.6g), moderate in calories (60) and has a generous 2.2g of fibre, which is uncommon in most yogurt drinks, she notes. 'It also delivers live cultures and gut-supportive ingredients, making it a smart daily option for digestive health.' Least healthy: Asda Vitamin+ Boosting Strawberry Flavour Yogurt Drinks 'In contrast, Asda ranks as the least preferred option due to the lack of research behind the product, as well as the relatively high sugar content, at 10g per 100g, which is more than two teaspoons,' Ludlam-Raine says. Unlike the M&S product, it also has no added fibre. 'While the label states it contains one type of bacteria, the relatively high sugar-to-benefit ratio makes it a less optimal choice, especially for daily use,' she says. 8. Gut health yogurt Yoghurt is already good for our gut, but those rich in 'good' bacteria – often indicated by the words 'live cultures' or 'probiotics' on the label – are extra beneficial for our health. 'They can support gut health, mental health, immunity and digestion,' Ludlam-Raine says. 'They tend to be low in sugar and offer a good balance of protein and calcium,' she notes. 'Choose plain varieties for less added sugar, and those with added fibre for even more gut health benefits – our good bacteria feed on fibre.' Healthiest: Activia Kefir Plain Yogurt 'Activia Kefir Plain stands out as one of the best options for gut health thanks to its combination of science-backed live cultures and a balanced nutritional profile,' Ludlam-Raine says. Unlike some kefir products that contain added sugars or high saturated fat, this option contains 4g of protein per 100g, moderate fat (3.5g), and no added sugar – all while delivering billions of live cultures. 'What makes Activia unique is the research behind the brand: the bacteria have been clinically studied for the effects on digestive comfort and gut transit time,' Ludlam-Raine notes. 'These strains are resilient enough to reach the gut alive, which is crucial for reaping probiotic benefits. Combined with its simple ingredient list and nice taste, Activia Kefir is a convenient and evidence-based way to support digestive health daily.' Least healthy: Tim's Greek Family Kefir Citrus Although this yogurt does provide a reasonable 4.8g of protein, this kefir is one of the highest in calories (139, twice as many as the Activia option), fat (8.1g), saturated fat (5.5g) and sugar (9.8g) in the list, Ludlam-Raine says. 'While it may still contain beneficial live cultures, the overall nutritional profile makes it a less suitable choice for those looking to support gut or heart health, especially if consumed regularly.' How to choose a healthy yogurt Short ingredient list 'Live' or 'active culture' labels Low in added sugar Good protein content It can be tricky to navigate the yogurt aisle but a simple way to spot a healthy option is by checking its ingredient list and selecting one that's not too long. Ideally, yogurt should just be made from milk and live cultures. 'Try to avoid frequently having yogurts that contain multiple artificial sweeteners, added sugars and thickeners (like aspartame, sucralose, glucose, modified starch),' Ludlam-Raine says. 'These may include dessert-style yogurts with cream, chocolate or sugary fruit compotes.' To ensure you're buying a yogurt that supports your gut health, look for one with 'live' or 'active cultures' on the label or description or the bacteria Lactobacillus or Bifidobacterium listed in the ingredients, she recommends. Your yogurt will also ideally be low in added sugar, ideally under 5g per 100g for plain yogurt, according to Ludlam-Raine. 'If it's flavoured, aim for under 10g per 100g and check that most of the sugar comes naturally from milk or added fruit,' she says. Yogurt is also a source of protein, so should have at least 5g to 10g per 100g, she adds. FAQs Is kefir healthier than yogurt? Both kefir and yogurt are healthy fermented dairy products but kefir has some unique advantages, Ludlam-Raine explains. 'It contains a wider variety of probiotic strains, including both bacteria and beneficial yeasts, which may provide stronger gut health benefits,' she says. 'Kefir also tends to be thinner and tangier than yogurt, and is fermented for longer, potentially leading to more bioactive compounds.' However, plain, live yogurt is still excellent for our health, especially if kefir isn't to your taste, she says. 'The best choice is the one you'll eat consistently, as part of a balanced, whole-food diet.' Is it ok to eat yogurt every day? It's healthy and beneficial to eat yogurt daily, especially if you are having a plain, unsweetened option. Research shows that three to seven portions per week is more effective for gut health compared to having it occasionally. What does live yogurt mean? 'Live' yogurt contains probiotics – bacteria which support gut health. If a yogurt is not described as 'live' it typically means it has been heated after fermentation, which kills off these bugs. Broaden your horizons with award-winning British journalism. 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Medscape
2 hours ago
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Preterm Birth Predicts Adult Health Problems
Adults born preterm were significantly more likely to have cardiometabolic risk factors and internalized mental health issues than full-term peers, according to an ongoing preterm birth cohort study in the US. 'This study addresses a significant gap in understanding the long-term health effects of preterm birth in the US,' said lead author Amy D'Agata, PhD, of the College of Nursing, The University of Rhode Island, Kingston, Rhode Island, in an interview. Although the annual preterm birth rate in the US has held at a relatively stable 10%-12% for decades, since the 1970s, more preterm infants are surviving because of advances in neonatal intensive care, D'Agata said. Millions of individuals born preterm are aging into adulthood, but few data are available on their long-term health outcomes, she noted. In the new study, published in JAMA Network Open , D'Agata and colleagues reviewed data from a cohort of individuals who received level III neonatal intensive care at a single center between 1985 and 1989. The study population included 158 preterm-born and 55 full-term born adult control individuals. Preterm was defined as weighing under 1850 g at birth with various neonatal diagnoses; critically ill infants and those with major congenital abnormalities were excluded. The mean age across the groups was 35 years; 50% were women. The researchers used latent growth curve models to show changes over time. Overall, the preterm individuals who had higher medical risk in early life were significantly more likely to have a range of health problems at 35 years of age, notably, higher triglycerides than control individuals (beta value, 53.97; P = .03). Measures of systolic blood pressure and central adiposity also were significantly higher in the preterm birth group (beta values of 7.15 and 0.22, respectively), whereas bone density and high-density lipoprotein cholesterol were lower (beta values of -1.14 and -13.07, respectively). In addition, internalizing mental health problems were significantly more common in the preterm cohort than in the control individuals (beta value, 0.85; P = .01) but no difference in externalizing mental health problems was noted between the groups. The researchers also reviewed the impact of social protection and childhood socioeconomic status and found no association between these and physical or psychological health risks in adults born preterm. The Long View of Preterm Birth The population of adults born preterm remains largely invisible to the US healthcare system and its clinicians, highlighting critical issues of health equity and quality of care, D'Agata told Medscape Medical News . 'Much of the existing research in this area has focused on international, homogeneous populations, creating a need for rigorous, US-based longitudinal data to guide healthcare policy and clinical practice,' she added. 'These findings generally confirmed what has been observed internationally, that there is a link between higher early life medical risk and increased likelihood of mental health issues, elevated systolic blood pressure, unfavorable cholesterol and triglyceride levels, body fat distribution, and lower bone density among adults born preterm, and it was notable to see these clear and consistent associations replicated in a US cohort using a prospective, longitudinal design,' said D'Agata. The study findings emphasized the need to inquire about birth history in adult care settings and suggest that those born preterm and their families must be their own health advocates, if necessary, said D'Agata. 'Even if a patient isn't asked about their birth history, they should share it,' she noted. Clinicians work hard to provide the best care, but it takes time for evidence-based research to inform clinical practice, she said. 'Although our birth cohort is small and comes from a single geographic region, the results generally align with international findings,' D'Agata told Medscape Medical News . However, future studies should include more racially and ethnically diverse cohorts from multiple clinical settings, she said. Research is needed not only to examine which subgroups of preterm individuals are most at risk but also to differentiate between those with varying degrees of early life complications, she added. Long Follow-Up Strengthens Findings The 35-year duration of the preterm birth cohort study was impressive and valuable, said Tim Joos, MD, a clinician with a combination internal medicine/pediatrics practice at Neighborcare Health in Seattle. 'We don't often have the long game in mind, in healthcare as well as in other parts of our society,' said Joos, who was not involved in the study. 'We don't tend to follow pediatric conditions into adulthood,' he noted. The current study findings demonstrated a long-term psychological and physical impact of prematurity on adult health that was humbling, Joos told Medscape Medical News . Looking ahead, the results highlight not only the need to continue to prevent preterm birth but also to the importance of asking older patients about preterm birth as part of their health history, he said.
