Optimising Men’s Health
Overview
- Statistics Relating to The Biggest Areas Impacting Men’s Health and Lifespan
- What is The Gut-Brain Connection and How Does it Relate to Stress and IBS
- How Do Sugar Cravings and Digestive Issues Relate to Diabetes and Heart Health and How Does This Relate to Testosterone Levels
- Men’s Hormones at Every Stage of Life and Ways to Improve hormone status for Better Wellbeing
- Opportunities for Improving Men’s Health from a Holistic Standpoint Looking at Diet, Lifestyle, Exercise and Nutrition Optimisation
Men’s health lacks awareness and focus, through passion and research I have collated what the main drivers are for ill health in males and what can be done to help men to recognise the signs, understand how their hormones work and find ways to feel better so that they can gain more energy, feel better in themselves, lose weight, increase focus and productivity to ultimately enhance their working and personal lives.
Statistics Relating to The Biggest Areas Impacting Men’s Health and Lifespan
Statistics From The WHO And The European Commission
➢ The State of Men’s Health Europe’, 2011 is the only study that the European Commission have produced on men’s health, so an update is certainly needed.
➢ The WHO have produced a Men’s Health Report and a Men’s Health Strategy more recently in 2018, which we will also explore.
➢ The WHO stated that ‘Men in the WHO European Region are living healthier and longer lives than ever before, but many still die far too young. The reasons behind this go beyond biology’.
➢ The report also revealed that, globally, boys born in 2018 could expect to live 68·6 years and girls 73·1 years, a difference of 4·5 years.
➢ ‘Global Action on Men’s Health’ surveyed 16,000 men globally in 2016 (sadly only really included US and Australia) but with a much more positive outcome
Global Statistics
Interestingly the life-expectancy gap between genders is larger in high-income countries than in low-income settingsBiology is important, but the biggest drivers of life expectancy are linked to social determinants of health. The single biggest killer of men under 45 globally and under 50 in the UK is suicide. That’s 12 men every day, one man every 2 hours. Overall, the single biggest killer is cardiovascular disease.
The WHO Believes That:
Strong beliefs, norms, attitudes, and stereotypes of masculinity may be prevalent and harmful for men’s health. These beliefs may create social barriers that prevent men from seeking medical services. Some health risks are behavioural (tobacco and alcohol consumption).
Men’s risk-taking behaviours and under-use of services are consistent across many countries and are linked to socioeconomic factors as well as to norms around masculinities and hegemonic ideals’.
- 86% of male deaths are attributed to noncommunicable diseases and injuries
- The main disease-related killers are cardiovascular diseases, cancers, diabetes and respiratory diseases
- Injuries are the second leading cause of premature death among men and the main cause of death for boys aged 5–19 in the region.
- Compared to women, men go less frequently to the doctor and consistently
Exposure to risk factors such as alcohol consumption, tobacco and other substance use, and being overweight are most prevalent.
Tobacco, alcohol and drug use are strongly determined by gender norms and roles and socioeconomic background and are more common among men of all ages.
Evidence also indicates that risk factors are highly interrelated and tend to cluster because of social and economic inequities.
Lack of knowledge about symptoms, treatment and services prevents men from contacting health services with sexual and reproductive health concerns.
‘To be healthy is not just about the absence of
disease; it is also dependent on being part of society,
having an education, a job, a family and to be able to
live a reasonably safe and secure life’.
– European Commission
Some Key Findings
Type 2 diabetes is increasing in men as a result of obesity.
Obese diabetics have a 40-60% higher risk of cardiovascular mortality.
Across Europe and the UK there are higher levels of chronic lower respiratory diseases in men. Around 4% of all male deaths result from this condition, which is mainly caused by smoking.
Osteoporosis is traditionally seen as a problem of older women. There are however problems of low bone density in young male athletes, men with specific health problems and hereditary factors.
Alcohol Usage
Alcohol-related harm is a major public health concern in the Europe and the UK. Alcohol consumption in Europe is the highest in the world. Men are more likely to be dependent on alcohol, and alcohol-related injury and mortality rates are significantly greater among men. Across Europe and the UK, deaths due to chronic liver disease are more common among men.
Dietary Pattens
Men’s diets are generally less healthy and less nutritiously balanced than women’s diets.
Despite the overweight/obesity epidemic, daily energy intake for men is below reference values.
Only German, Norwegian and Polish men meet the recommended daily dietary fibre intake.
Majority of men are above the recommended range of fat in total energy intake, saturated fatty acids, and cholesterol.
Polyunsaturated fatty acids are below the recommended intake range in most of the participating countries.
There are a number of instances of vitamin deficiencies among men in the EU and UK and the intake of certain minerals is at odds with recommend levels.
Obesity
Men tend to deposit fat intra-abdominally leading to an apple shape, compared to a pear-shape in women.
In Germany, UK, and Malta over 65% of men have a BMI greater than 25.
In Norway, Estonia, Latvia and France, fewer than 45% of men are overweight.
Cardiovascular Disease
There have been marked reductions in cardiovascular morbidity and mortality.
Nevertheless, CVD is still one of the biggest risks to men’s health and in the older population.
In fact, it is the principal cause of death. Ischemic Heart Disease, (IHD) is responsible for 360,000 deaths among men in the EU and UK, about 15% of all mortality.
Cerebro-Vascular Disease (stroke) constitutes 8% of all male deaths or nearly 200,000 lives lost.
Type 2 Diabetes
Type 2 diabetes is associated with central/visceral obesity and development of the metabolic syndrome.
1.Too much fat at the waist
2.High blood pressure
3.High triglyceride levels
4.Low HDL cholesterol
5.High fasting glucose (blood sugar)
This then significantly increases the risk of cardiovascular mortality.
Men are more likely to remain undiagnosed for longer as a result of less frequent use of health services. Men have a higher rate of mortality from this type 2 diabetes.
Cancer
Cancer accounts for a 1/3 of all male deaths in the EU and UK each year.
Men develop and die sooner from cancers that should affect men and women equally.
- Colorectal cancer is a leading cause of cancer death in the EU and UK and requires population-based screening.
- Lung cancer is declining.
- Testicular cancer (despite effective treatment) is the first cause of cancer death among young males (20-35 years).
- Prostate cancer has become the most diagnosed among European males affecting around 1 million men.
Mental Health
Men’s depression and other mental health problems may still be under-detected and under-treated.
This may be due to:
– Men’s difficulty in seeking help
– Health services’ limited capacity to reach out to men
– Men’s different presentation of symptoms to women
– Higher levels of substance abuse and challenging behaviours
– Schizophrenia onset is earlier in men than women.
– Men have poorer long-term outcomes, longer inpatient stays and extended periods of impaired functioning.
Depression (mood affective disorder) is one of the most prevalent health problems and there are marked gender differences.
– In fact, hospital admission rates and attendance at a general practice showing women outweighing men by a ratio of 2:1.
– The reason for these large differences is not explained by current research.
– However, particularly among men, depression is under-treated.
– This partly reflects known sex differences in help-seeking behaviour.
What is The Gut-Brain Connection and How Does it Related to Stress and IBS?
The Gut-Brain Connection
Biochemical signals via the vagus nerve regulate mood, memory and much more Dopamine, serotonin and norepinephrine travel from the gut to the brain. Imbalances in the gut microbiome can cause inflammation due to poor diet. If you have IBS you are 3 times more likely to have anxiety and depression.
How Does The Gut-Brain Connection Relate to Stress and IBS?
Our gut instincts are real: getting butterflies when we’re nervous happens because our nervous systems and our digestive systems are intertwined.
It is now more widely accepted that our brain talks to our gut and our gut talks to our brain, and that there is a two-way communication, meaning that our thoughts can influence our gut bacteria and visa versa.
Giving the digestive system a chance
to rest is key because when we’re
constantly stressed, fearful anxious
or worried, this can impact our
digestive system too.
Remaining calm, doing breathing
exercises and mindfulness
techniques can be really beneficial
for our nervous system and also for
How Does The Gut-Brain Connection Relate to Stress and IBS?
The effects of chronic and acute stress on the gut-brain microbiome network have been well documented.
For example, stress mediators such as norepinephrine, adrenalin and cortisol can cause a cascade of events when they are released into the gut.
They can activate microbial genes that increase bacterial communication between the immune system. This can set off an immune reaction, which can cause autoimmune conditions and leaky gut.
People exposed to chronic stress may age rapidly. Telomeres may shorten faster. Inflammation may cause ‘Inflammaging’. Oxidative stress is one of the main mechanisms related to stress.
Good Stress
Some of the latest research surrounding stress has identified two types of stress. ‘Threatened response’ stress versus ‘challenge response’ stress.
Some individuals may be genetically hardwired towards the more damaging and ageing ‘threatened’ stress that activates the sympathetic side of there nervous system and is pro-inflammatory, whereas some other individuals may be genetically hardwired towards the more ‘challenge
response’ stress whereby they see a stressful situation as a challenge, which secretes different kinds of hormones and reactions in the body and has a less damaging effect on the ageing process, such a telomere length.
Fight or flight is the body’s automatic
physiological response to stress or danger. It
prepares for action by increasing heart rate,
dilating airways, and releasing stress
hormones like adrenaline and cortisol.
Sugar
Individuals may often feel the need for a dopamine hit. But doing this over and over again may lead to a dopamine deficit as we wear down the receptors by then wanting/needing more.
1 – Sugar also drives inflammation in the body.
2 – Sugar may ferment in the gut feeding our unwanted gut bacteria, causing possible SIBO
and IBS (bloating, gas, uncomfortable feeling).
3 – Insulin resistance is another big driver for health related issues
What about male hormones?
Male Hormones in a Nutshell
- Androgens are crucial for male sexual and reproductive function. They are also responsible for the development of secondary sexual characteristics in men, including facial and body hair growth and voice change.
- Testosterone is the primary sex hormone and anabolic steroid in males. It plays a key role in the development of male reproductive tissues, as well as promoting sexual characteristics such as increased muscle and bone mass, and the growth of body hair. It also plays a role in red blood cell production, iron metabolism and can act as an anti-inflammatory.
- DHT is estimated to be around five times more powerful than testosterone. Testosterone and DHT both bind to the same receptors. However, DHT does so more efficiently. An overproduction of DHT is known to cause a number of undesirable health effects in men including enlarged prostate and male pattern baldness.
Male Menopause
Male menopause, or andropause, refers
to age-related hormonal changes in men,
including declining testosterone levels.
Symptoms may include fatigue, mood
swings, reduced libido, and changes in
body composition.
Hypogonadism
Hypogonadism is a medical condition where
the body’s sex glands (testes in men, ovaries
in women) produce insufficient sex
hormones, leading to various symptoms like
low energy, low libido, and infertility.
TRT
TRT, or Testosterone Replacement
Therapy, is a medical treatment for low
testosterone levels in men. It involves
administering synthetic testosterone to
alleviate symptoms like fatigue, low libido, and mood changes.
The chicken and the egg situation regarding low testosterone and metabolic syndrome…
Men with obesity, metabolic syndrome, and type 2 diabetes may also have low total and free testosterone.
Low testosterone may predict the development of metabolic syndrome and type 2 diabetes.
Visceral adiposity with low testosterone, metabolic syndrome, and/or type 2 diabetes acts through pro-inflammatory factors.
These inflammatory markers may contribute to vascular endothelial dysfunction leading to increased
cardiovascular disease (CVD) risk and erectile dysfunction.
Metabolic Syndrome and Type 2 Diabetes are linked Vascular lining – endothelial dysfunction – sexual dysfunction -metabolic issues – low T – insulin dysregulation.
In these instances, all the associated outcomes of T2DM and metabolic syndrome lead to an environment that’s ideal for hypogonadism.
That includes excess adipose tissue, increased sedentary behaviour, and insulin and leptin resistance.
Men’s Hormones at Every Stage of Life and
Ways to Improve hormone status for Better
Wellbeing
Opportunities for Improving Men’s Health from
a Holistic Standpoint Looking at Diet, Lifestyle,
Exercise and Nutrition Optimisation.
Opportunities for Improving Men’s Health
➢ Spot the signs of health anxiety
➢ Encourage reassurance
➢ Information and guidance
➢ Look out for biohackers and type A’s
➢ Look out for gym enthusiasts
➢ Look out for signs of ADHD
➢ Look out for signs of low self-esteem
➢ Check metabolic stats (HbAc1, cholesterol, blood pressure)
➢ Break unhealthy habits with the psychology of eating
➢ Getting checked for colon, prostate and skin cancer among others
➢ Ensure good support networks
Teenagers
Fat can become leptin resistant, produce more leptin, which releases more testosterone, causing early puberty.
Reaching puberty too early may impact hight and stature.
Growing up chubby or fat may change body composition.
18 is a good age to get blood work done, and then usually every 6 months.
Key markers to check from this age onwards:
Testosterone, SHBG binds oestrogens and androgens, free testosterone, as SHBG may impact DHT.
Ages 20-30
Fibre is so important for setting the gut microbiome for the rest of a persons’ life.
Pre and probiotics
Essential fatty acids are key for brain development.
Learning to to cope with stress
Over stress can impact all of the lifestyle pillars.
Getting outside helps increasing Vitamin D.
Mindfulness.
Athletes may need to supplement but food first.
Midlife
Declining male hormone levels.
The need for testing and assessing.
Watch out for signs of midlife crisis.
-No longer as youthful feeling/looking
-Achieved a lot
-Burnt out
-Needing a career or life change
-High stress
-Poor sleep
-Poor diet
Address these issues with family, friends and healthcare providers.
Older Years
Increased need for testing and prevention of CVD and other noncommunicable diseases.
Increased need for prevention of communicable diseases (COVID-19).
Lower the risk of falls and fractures with increased targeted supplementation.
Exercise the brain and body.
Alcohol
Recommended <14 units per week for men.
Binge drinking puts additional pressures on the body.
Too much alcohol may result in:
➢ Elevated oestrogen
➢ Decreased testosterone
➢ Decreased IGF-1
➢ Impaired fertility
➢ Increased liver strain
➢ Worsens stress and anxieties
➢ Shortening lifespan
Malnutrition
Eating too little essential nutrients, or excess calories to the point of insulin resistance and increased weight, may negatively affect testosterone levels.
Obesity and low serum testosterone levels are interrelated and strongly influenced by dietary factors.
Evidence suggests a bidirectional relationship between nutrient, glucose, lipid, and iron levels and testosterone levels.
Weight Management
A resistance trained male eating in a moderate caloric excess may see slight increases in testosterone.
Contrastingly, long-term calorie restriction, particularly in the extremes, may lead to lowered
testosterone, even if getting adequate micronutrients.
Being significantly underweight also causes reductions in testosterone.
Hypogonadism can often persist even after weight restoration.
Foods to Focus on
➢ Green leafy vegetables and colourful fibre
➢ Reduce and swap more red meat consumption
for white meat, eggs, fish (especially fatty fish), and plant proteins.
➢ Increase nuts, oats, milk, cheese, broccoli, green beans, salmon, chicken and legumes.
➢ Eat more poly unsaturated fatty acids, often found in fatty fish.
➢ Eat whole non-processed foods, avoiding trans fats.
Specific Nutrients for Men
➢ Biocare is a male multi-nutrient that contains nettle root and has seen success in symptoms in male clients, but it contains higher levels of B vitamins
➢ Igennus is a male multi-nutrient that has lower levels of B vitamins, no Mg but may be better long-term. It does contain lycopene.
Always speak with your GP or Registered Nutritionist before trying any new supplements
Vitamin D
➢ Vitamin D may increase testosterone
➢ Testing is advised initially and then re-test every 6 months
➢ Supplement with Vitamin D if needed (4,000iu upper limit)
➢ It may depend on how much sunlight a person gets (type of work)
➢ 20 minutes a day with arms on show can increase levels adequately
➢ The darker skin, the more vitamin D a person may need
Always speak with your GP or Registered Nutritionist before trying any new supplements
Zinc
➢ Some men make increase zinc intake for low testosterone
➢ The balance zinc/copper ratio is important, as copper and zinc compete for binding sites and excess zinc
may also decrease iron levels.
➢ Ideal ratio is 8:1 zinc/copper
➢ Studies have observed low iron in TRT clients
➢ RDA for male zinc intake is 11mg p/d
Always speak with your GP or Registered Nutritionist before trying any new supplements
Omega-3
➢ The benefits of omega-3 cannot be underestimated for overall health
➢ Current thinking suggests that we may need omega-3 daily for optimal needs
➢ Omega 6-3 ratio is key for cell membrane health, dampening inflammation, heart, brain, eye, joint health
➢ EPA (anti-inflammatory) DHA (brain health) ADHD, mood, immune health
➢ 3g p/d (olive oil and polyphenols)
➢ Not to be taken in conjunction with blood thinners/aspirin
Always speak with your GP or Registered Nutritionist before trying any new supplements
Iron
➢ Iron is needed to make haemaglobin and hormones
➢ RDA for men is 8mg p/d and for women it is 18mg p/d
➢ High single doses of some forms of iron can have side effects and iron toxicity
➢ Spartone liquid iron is slow build up/gentle iron
Always speak with your GP or Registered Nutritionist before trying any new supplements
Magnesium
➢ Magnesium supports muscle and nerve function and energy production
➢ Chronically low magnesium may increase the risk of high blood pressure, heart disease, type 2 diabetes and osteoporosis
➢ RDA for men is 400-420mg p/d
➢ Igennus Magnesium Complex works well in combination with Igennus Male Multi
Always speak with your GP or Registered Nutritionist before trying any new supplements
Probiotics
➢ Antibiotics can strip the gut bacteria by up to 90%.
➢ Studies have shown that taking Saccharomyces boulardii while taking antibiotics can support.
➢ Studies have also shown that prebiotics taken with fermented foods help to increase diversity and increase immunity.
➢ That being said, if someone has significant digestive issues, then they may need to run a stool test to assess for pathogens that may need removing first.
➢ Client case: stool test showed no pathogens, but low levels of beneficial bacteria and slight inflammation. Supporting with pre and probiotics and omega-3.
Always speak with your GP or Registered Nutritionist before trying any new supplements
Other Beneficial Known Supplements for Men
- Maca Root
- Horny Goat Weed
- Pcynogenol
- Lycopene
- Nettle Root
- Biotin
- Saw Palmeto
- Panax Ginseng
- Green Tea
Sleep
➢ 7 to 8 hours is optimal
➢ Poor sleep lowers testosterone levels
➢ In a healthy sleep routine:
➢ LH secretion peaks during sleep, requiring a minimum of at least 3 hours of sleep
Shift work can impact this as can sleep apnoea and being overweight:
Calorie restriction diet and see if a large amount of weight loss helps to improve it.
Physical Exercise
➢ Male healthy body fat percentage is between 10-17%)
➢ Resistance training/strength training routine along with cardiovascular exercise such as running and cycling is most beneficial
➢ Daily cardiovascular exercise
➢ Resistance bands, body weighted routines can be used in place of a gym
➢ Standing desks, taking frequent mini breaks and getting up walking about
➢ Being careful not to overtrain
Other Important Factors to Optimal Health for Men
- Health literacy means being able to read pamphlets, make medical appointments, understand food labels or follow a doctor’s advice.
- Ability to gain access to information which promotes and maintains good health.
- And the ‘capacity and the intention of an individual to take action based on their knowledge and awareness of their particular situation and condition – physical and mental.’
- Although men are generally more likely to be physically active than women, a significant proportion, about a quarter (23%), are deemed to be insufficiently active.
- Risk Avoidance or Mitigation
- Men are also more likely to consume food at risk of contamination with live pathogens, such as undercooked hamburgers, raw oysters and runny eggs, and to have poorer oral health practices.
- Men are less likely to seek help from primary healthcare services than women.
- Men are particularly reluctant to seek help for mental health problems.
- Men are more likely to miss general practice appointments they have already made.
Resource Recommendations
➢ Men’s Health Forum https://www.menshealthforum.org.uk/more-about-us
➢ Man Health https://www.manhealth.org.uk/
➢ Movember https://uk.movember.com/
➢ The State of Men’s Health Europe https://op.europa.eu/en/publication-detail/-/publication/8c207181-b7ac-46b8-8e63-f418cc39e53c/language-en
➢ Prof Alan White https://www.alanwhitemenshealth.co.uk/
➢ Peter Baker http://pbmenshealth.co.uk/