WebMD The Magazine - Feature
Michael W. Smith, MD
Guys, you are not invincible. That's the message men's health experts wish you would learn. The earlier, the better. You already know the drill: That means a good diet, frequent exercise, and routine trips to the doctor. But it's often not until men are into their 60s, after decades of self-neglect, that their thinking begins to change.
"That's when they start to see changes that are not ideal and start to make caring for themselves a more regular practice," says Ajay Nehra, MD, a urologist and men's health expert at the Mayo Clinic. "The attitude among men is, 'If it's not broken, why fix it?'"
It's time to adjust that attitude before things do begin to break, at an age when it's often harder to fix them. Here is our guy's guide to helping you start taking better care of yourself.
Routine checkups are the backbone of preventive health care, yet a large government survey found that few men regularly see a doctor. And when a man does finally get to the doctor? It's only after his significant other has put her foot down. "Spouses and partners are the drivers that force men to get evaluated," says Nehra.
Scott Fields, MD, a family medicine specialist at Oregon Health & Science University, sees that same reluctance to focus on long-term health and its maintenance among his male patients. "Men in their 20s and 30s are still in the mode that they are pretty invincible," says Fields. "For that age, I focus on lifestyle issues such as alcohol and recreational drug use, smoking, and unsafe sex. If you can get all that behind them, you can help them with their long-term health."
But too often, says Fields, men favor "denial and avoidance" when it comes to their health care, at least until they can no longer ignore whatever's ailing them. Fields says it's often fear of cancer or heart problems that finally gets them into his office.
"Most of the time, the fear is just that -- fear," Fields says. "It's something we can reassure them about." But Fields has a bigger goal, "getting men acculturated to the concept that having ongoing health care and health maintenance is an important part of staying healthy."
The latest guidelines say you need at least 30 minutes of moderate aerobic exercise five days a week. That means cardio training, whether it's walking fast, running, rowing, or biking -- anything that will make you sweat and get your heart really pumping. Strength training is important as well, so at least twice a week, add some weights, resistance bands, or body weight exercises such as push-ups and pull-ups to your routine.
But among guys who already exercise, says Fields, too many focus their efforts on lifting weights to the exclusion of everything else. "You see more guys in the weight room and more women doing cardio," says Fields. "The numbers should be equal."
Don't forget to do a few minutes of warm-ups prior to your workout. Walk, jog, or bike lightly to prep your muscles for more intense exercise. You should also add some stretching to your routine to improve your flexibility and athletic performance and lower your risk of injury.
Regular exercise lowers LDL "bad" cholesterol, protects against high blood pressure, wards off depression and stress, and helps you live longer. And by fending off those common problems, you won't have to crowd your medicine cabinet with prescription drugs. That, says Fields, has been a strong incentive for his male patients to start working out.
"If you can have a conversation about how they'll need fewer medications if they exercise, they will listen."
Maintaining your proper weight is an essential part of staying healthy, and exercise alone won't do it, especially for men in their 40s and beyond.
"A lot of men only know how to control their weight by exercise, but as they are getting older, their metabolism is slowing down," says nutritionist Manuel Villacorta, RD, MS, CSSD, owner and founder of MV Nutrition in San Francisco as well as the web site eatingfree.com. "They may be eating the same amount of calories, but they are not burning it off as readily."
You can cut down on calories and still feel full by making sure you have plenty of whole-grain foods in your diet. The body takes longer to digest them, and that means more time between hunger pangs. Just don't put too much time between meals, says Villacorta, whose clients are mostly men. "Eating something healthy every three to four hours helps to keep up metabolism," he says.
Along with paying attention to what -- and how much -- you eat, Fields says it is essential to rethink what you drink. "Juices, for example, are really high in calories, as are sodas and alcohol. So I start with figuring out what [men] drink."
With alcohol, of course, you're watching more than just calories. Too much alcohol is bad for your liver as well as your waist. Villacorta says that for health reasons, men should not drink more than two servings a day. A serving means one beer, one 4-ounce glass of wine, or a 1.5-ounce shot of liquor. When it comes to weight loss, even less is ideal.
"My recommendation for men trying to lose weight is to keep it to seven servings per week," he says. Keep in mind that restaurants pour about six ounces of wine per glass, and cocktails usually consist of two or more shots, so you're looking at about four drinks per week if you are going out.
There are at least 6 million depressed men in the U.S., according to the National Institute of Mental Health. The real number is a lot higher. Why? A lot of diagnoses are likely missed because men don't want to discuss their feelings or they are afraid that being diagnosed with depression will mean they're less manly.
Nothing could be further from the truth. Depression is as much about brain chemistry and genetics as it is about how you respond to the death of a loved one or financial disaster, for example.
Whatever the cause, the cost of not talking about what you're going through is high: Men often choose alcohol and drugs over asking for help, and men account for 80% of suicides in the U.S. each year.
As devastating as depression can be to your mental well-being, it can take a huge toll on your body as well. "Depression has been associated with cardiovascular disease, stroke, and erectile dysfunction," says Nehra. Don't try to tough it out. If you've been feeling down for more than a couple of weeks, see a doctor.
"Stress and depression are kissing cousins," says Fields. But, he says, stress is often very difficult to get men to discuss because they think they need to be stoic in handling problems. "It's easier for men to talk about erectile dysfunction than it is for them to talk about depression or stress."
Stress often shows up as physical complaints, like headaches or stomach pains. "It's very common to tease it out from such symptoms," he says.
Stress is best caught early and quickly, because it can cause trouble in all areas of life: It shoots up blood pressure, upsets digestion, and weakens your immune system. It can also wreak havoc in the bedroom. Nehra's had plenty of patients who complain they can't get even a partial erection. His diagnosis? Stress.
"Stress is associated with low libido," he says. "It affects you psychologically as well as physically."
Exercise can help reduce stress, says Nehra. So can getting enough sleep.
Stress, alcohol, drugs (prescription and over-the-counter), low testosterone, performance anxiety: The list of what can sap your appetite for sex goes on and on. But getting help can often get your sex drive back on track. And men, says Fields, are more open to talking about sex problems than ever before.
"We have [former Senator] Bob Dole to thank for that," he says. "Discussions about erectile dysfunction are increasingly common. I have two to three conversations about it each week."
If other men are talking about it, so can you. Schedule an appointment with your doctor to determine what's causing the problem. Just don't be surprised if you end up on the couch.
Nehra sees many patients with low libido in his urology practice, but he doesn't hesitate to refer them to a psychologist when the problems don't originate below the belt.
Breakfast. It's still the most important meal of the day to jump-start your metabolism, Villacorta says. Try reaching for 1 and 1/2 cups of cooked steel-cut oatmeal (whole grains, high in fiber). Add a cup or so of blueberries (loaded with antioxidants), 2 tablespoons of flaxseeds (a good source of fiber and omega-3 fatty acids), and nonfat plain Greek yogurt (a great source of protein and calcium). Stir together. Enjoy.
Lunch. Keep it fairly light; a big meal will leave you sleepy. Villacorta recommends a healthy burrito. Start with a whole-wheat tortilla (whole grains) and add 4 to 5 ounces of lean meat, such as grilled chicken (protein), beans (complex carbs and protein), plus tons of salsa (fat-free) and some sliced avocado (healthy fat). Hold the sour cream and cheese.
Dinner. It's best to eat your evening meal at least 90 minutes before bedtime, says Villacorta. He suggests keeping it simple. Try 4 to 5 ounces of grilled salmon (omega-3 fatty acids and protein), a cup of quinoa (complex carbs and whole grains), and cooked vegetables, such as spinach or broccoli.
SOURCES:Agency for Healthcare Research and Quality: "Variation in Ambulatory Health Care Visits and Visits for General Checkup by Demographic Characteristics and Insurance Status, U.S. Civilian Noninstitutionalized Population Ages 18-64, 2005."Ajay Nehra, MD, urologist, Mayo Clinic, Rochester, Minn.Scott Fields, MD, vice chair, department of family medicine, Oregon Health and Sciences University, Portland.CDC: "How much physical activity do adults need?"Manuel Villacorta, RD, MD, CSSD, San Francisco.Harvard Medical School: "Eat, Drink and Be Healthy."National Institute of Mental Health: "Men and Depression."Mayo Clinic: "Male Depression," "Stress symptoms: Effects on your body, feelings and behavior," "Stretching: Focus on Flexibility."
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