For Paul Quetua, MD, a Cardiologist at Makati Medical Center (MakatiMed), the troubling trend these days is not just that there are more Filipinos diagnosed with hypertension, heart disease, diabetes, obesity, fatty liver, cancer, and other non-communicable diseases (NCDs) that impact the heart. Rather, it is that many of these Filipinos are in their 30s and 40s, a relatively young age to have conditions that usually appear later in life.
What is going on? Youth and evolution, he says. In our teens and 20s, our frontal cortex, that part of our brain in charge of decision-making and impulse control, is still in its developing or fine-tuning stage. This explains why we are likely to engage in smoking, drinking, illicit drugs, and taking on other unhealthy habits in our younger years.
How Lifestyle Choices Shape Long‑Term Heart Health
“The mindset in your 20s is that you are invincible,” says the Cardiologist. “We need to eliminate that mindset. We need to think that the 20s are the foundation for our general health for the rest of our lives. Our health in our 30s, 40s, and 50s is rooted in the habits we form in our 20s.”
The MakatiMed doctor enumerates five (5) ways 20-somethings are sabotaging their heart health—and what they can do to ensure a long, active life in the years to come.
1. Poor Diet Choices
These stem from the convenience and irresistible flavors of fast foods—from juicy burgers, deep-fried chicken, and addictive French fries high in calories, sodium, and trans fats to sodas, milk teas, and white rice loaded with sugar. Consume them on a regular basis, and you set yourself up for high blood pressure, stroke, heart attack, diabetes, fatty liver, obesity, and even cancer.
“At an early age, we often advise our patients to cook and prepare [their own] food,” says Dr. Quetua. “If you have the habit of preparing your food for the whole day, the convenience of fast food is gone. And of course, it is much healthier [because] you are in charge of the ingredients and the amount of food that goes into your body.”
To feel full for hours and resist the urge to order a greasy burger and fries, the doctor recommends eating healthy protein and fiber. Lean chicken, fish, soy products, and eggs are examples of the former, while the latter includes whole grains, leafy greens, and fresh fruits.
2. Vices
Smoking, drinking, and taking recreational drugs are habits borne out of curiosity, peer pressure, or the desire to feel better, look cool, or escape temporarily from a stressful situation. Whatever the reason, it does not benefit the heart in any way.
“In terms of cardiovascular health, smoking destroys the arteries. It makes the arteries inflamed and prone to developing cholesterol blocks, explains Dr. Quetua. Over time, these cholesterol blocks will make blood vessels tighter and tighter, impeding blood flow and resulting in a heart attack. Smoking can also block arteries in the brain, leading to stroke, or in the legs, which may result in Buerger’s disease and inevitable amputation.
Consumed in excess, alcohol increases your risk of heart failure, hypertension, and stroke, as can illicit drugs, which mess up your heartrate either by speeding it up or slowing it down.
If you practice any or all of these vices, quit. If you are thinking of starting even one of them, do not. “There are a lot of studies that say that people who try cigarette smoking, vaping, illegal drugs, or drinking alcohol in their teenage years or in their 20s are more likely to still be doing them in the future,” says Dr. Quetua. “But if they abstain or do not partake in these vices, the chances of having them in the future becomes very low.”
3. Obesity
Obesity has reached a crisis point in the Philippines. According to a March 2025 report from the World Health Organization (WHO), nearly four (4) out of 10 Filipino adults are considered overweight and obese—a consequence of indulging in ultra-processed and fast foods and not moving enough to burn the excess calories. “People in the 1960 and ‘70s were generally thinner than people who are in their 20s now because of those bad habits,” notes the MakatiMed doctor.
Besides eating healthy and practicing portion control, regular exercise gradually brings your weight down and strengthens your heart. Dr. Quetua suggests at least 30 minutes of light to moderate activity every other day. Walking, jogging, Pilates, yoga, even cleaning doing household chores counts as exercise.
“If possible, the exercise should be something that will not injure them,” he says. “Too much exercise and too strenuous exercise are also not good.”
Indeed, not only can you end up with years of chronic pain from a banged-up shoulder or torn ligament, but weekend warriors who sign up for hours-long 42K or consecutive games of pickleball are straining their heart and lungs. Dr. Quetua cites a study that revealed irregular heartrates among cross-country skiers and marathon runners.
4. Not getting enough sleep
Inadequate sleep is something a lot of people are all guilty of in their youth. “I remember when I was in my 20s, I could party until 3am and go to work the following day as a medical doctor, as early as 6am or 7 am,” admits Dr. Quetua with a chuckle. “When we were in training, sometimes we go on duty without sleep for 36 hours.”
Now, of course, he knows better. Depriving yourself of the recommended eight (8) hours of sleep a night triggers the production of stress hormones. It also accelerates atherosclerosis, or the buildup of plaque in the arteries. “Sleep is actually the time when we are getting healed. So, it is really important, not only for the heart, but for the whole body, especially the brain,” he says.
How to get a good night’s rest? Turn off those gadgets. The blue light emitted by phone, tablet, and computer screens suppresses melatonin, the hormone that helps us sleep. And exciting content from social media and streaming services stimulate our senses, keeping us awake.
5. Skipping a consult
This is typical when someone is in their 20s and feeling fine. No need to see the doctor, right? Wrong. As NCDs are on the rise, it helps to know early if you are at risk, or if you already have high blood pressure, high blood sugar, or elevated cholesterol—conditions that often show no symptoms and can only be detected through blood work.
A visit to your primary care physician is also a chance to update your vaccines for the flu, pneumonia, hepatitis B, and the human papillomavirus. As cancers are being diagnosed among members of a young population, a simple checkup can either rule out their presence or detect the disease early enough for immediate treatment. Females in their 20s should get their Pap smear every three years and perform a self-breast examination three (3) to five (5) days after their monthly period. The 20s are also the time men should do a monthly self-examination of their testicles and scrotum for testicular cancer.
“Before, it was unheard of to have a medical check when you’re in your 20s. But nowadays, you can easily reach a professional for your medical or mental health concerns. Even companies are now doing screening tests for people in their 20s,” says Dr. Quetua.
The saying “you have your best years ahead of you” does not just refer to your 40s or 50s; it means your 60s and beyond too. Continue to explore and experience the best that the world has to offer as a happy, healthy senior by taking care of yourself in your 20s.
“If you have good habits at an early age, the chances are those good habits will persist until you are in your 60s or 70s and will help you a lot in your twilight years,” concurs Dr. Quetua.
Article based on Healthline with MakatiMed guesting of Paul Quetua, MD, last September 2, 2025.
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