Let’s talk about men’s health…
June is Men’s Health month, a time designated to increase awareness of preventable health problems among men.
It is always a good time to be proactive about your health, but making healthier food and lifestyle choices can feel easier as we head into summer.
Historically, the traditional man was loved and respected for his courage, strength and bravery, especially when protecting family and country. Yet… when it comes to their health, men tend to ignore or shrug off health concerns or symptoms as in… “If it ain’t broke, don’t fix it!”
Research shows that, compared to women, men are more reluctant to consult health care providers about worrisome physical symptoms or mental health concerns (1). Men are also less likely to go for annual check-ups than women. This may be a contributing factor for why women typically outlive men.
In 1900, the life expectancy gap between men (46.3 years) and women (48.3 years) was just 2 years. As of 2021, men now lag behind women in life expectancy by approximately 6 years: 73.2 years for men vs. 79.1 years for women (2).
Men’s Health: Where men are vulnerable
The 3 leading causes of death for men are 1) Heart disease, 2) Cancer and 3) Unintentional injuries (3).
When it comes to the heart, men are more likely to:
–Have coronary heart disease—and likely not know it (4). That’s:
–1 in 13 white men
–1 in 14 black men
–1 in 17 Hispanic men
–Experience a heart attack—and at an earlier age—than women (5).
–Have no symptoms. Half of men who die suddenly from heart attacks had no previous symptoms (6).
–Have a heart attack—and not even know it (7)! This is technically known as a silent myocardial infarction (SMI), or a “silent heart attack”. In a study published in Circulation, the incident rate of SMI for men was nearly double that for women (8).
How can you have a heart attack and not even know it??!!
The signs and symptoms of a silent heart attack (SMI) can include:
Mild, center-of-the-chest pain; inexplicable fatigue; sluggishness; heartburn; shortness of breath, nausea; vomiting; dizziness; weakness; mild pain in the throat or jaw; or a sprain-like pain in the neck or arm.
Men often ignore SMI symptoms, attributing their physical discomfort to overwork, poor sleep, a bad meal (if it feels like indigestion or acid reflux), or they may perceive their aches and pains as a “normal” part of of “aging”(9, 10).
*The risk of a silent heart attack increases for men ages 45 and older.
–Men are significantly more likely to be diagnosed with—and die of—cancer (all types) than women (11).
–Men are less likely to seek treatment for mental health issues, like anxiety or depression, resulting in a nearly 4x increased likelihood of committing suicide. Middle-aged white men are most vulnerable (12).
Why Don’t Men Prioritize Their Health?
Why? Professionally—and personally—I have heard variations on the following common excuses:
1 “I feel fine.”
Unfortunately, men tend to set the bar for “feeling fine” very, very low. As a behavioral and functional health coach, I often work with men who decide to pay attention to their heath only after they have experienced painful or uncomfortable consequences of a chronic condition, like diabetes or an autoimmune disease, or after an acute episode, such as a heart attack, stroke or post-surgery recovery.
2. “I’m busy!”
This is a big one. My husband has snapped this retort at me on several occasions after I reminded him to schedule his annual bloodwork! Men can be very focused, driven and preoccupied with their work. This excuse, however, can also subconsciously be tied to either (or both) of the following thoughts…
3. “My chronic joint pain, gut issues, persistent indigestion / acid reflux, stubborn weight gain, numbness, swelling, blood in urine/stools, brain fog, depression, heart palpitations, sleep apnea, anxiety, etc. will go away on its own.”
The idea is that by willfully ignoring what ails you, those irksome symptoms will miraculously disappear with time.
4. “I’m afraid of what I’m going to find out…”
Contemplating the worst-case scenario with regards to our mortality can feel acutely uncomfortable. A fear of the unknown, especially with regards to health, is common among men. Change can feel scary, whether it means making different food choices, potentially giving up favorite foods, drinking less alcohol, scheduling more time for rest and relaxation, committing to a new routine, or weaning off unhealthy lifestyle habits or recreational substances.
5. “I don’t need to see a doctor…” OR “I don’t want to take medications!”
Many men associate seeing a doctor with having their health “managed” by a regimen of prescription medications, like a statin, beta blocker or anti-depressant, which can make men feel “old”, powerless, weak and/or unmotivated to engage in healthy lifestyle practices. Yes, it is true that conventional medical doctors often prescribe medications to manage symptoms.
The good news? You do not have to see a conventional medical doctor! You can make other choices when addressing health concerns—and without immediately resorting to pharmaceuticals. For example, you could consult a naturopath, chiropractor or acupuncturist for a more holistic diagnosis and treatment. Or….you could work with a functional health coach, like myself, to improve—or to prevent a worsening of—symptoms through food choices, lifestyle habits, supplementation, mindfulness and relaxation strategies.
Are You Metabolically Healthy?
A 2018 study found that, among American adults, ages 20 and older, only 12 percent were metabolically healthy (13)!
In other words, the vast majority (88%) of American adults, aged 20 and older, were metabolically unhealthy. After the COVID debacle of the last three years, that 88 percent has undoubtedly risen even higher.
What is metabolic health anyway…and why does it matter?
Your “metabolic health” reflects the overall health of your cells in a wide range of biological functions (e.g., growing new cells, repairing tissues, storing energy or releasing energy to facilitate bodily functions).
What does optimal metabolic health feel like?
–You have stable energy throughout the day—without caffeine or sugar.
–You have good cognitive function; you can focus, think clearly and have sharp recall.
–You have physical stamina: you are mobile and active without restriction.
–You are at a healthy weight and burn fat easily.
–Your mood is balanced; you experience minimal anxiety / depression.
–You have a clear complexion.
–You have excellent reproductive health (no fertility issues).
–You have a strong immune system.
–You are at low risk for chronic diseases, like heart disease, diabetes or stroke.
FOR MEN, the 5 key indicators of metabolic health are the following WITHOUT the use of medications:
1. Waist circumference.
Waist size is a unique indicator of body fat distribution. A large waist size is a strong predictor of an increased risk of cardiometabolic diseases, such as heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease (NAFLD).
MEN: You want a waist size that is LESS than 40 inches, ideally, in proportion to your height and weight.
2. HDL (“good”) Cholesterol.
HDL removes “bad” cholesterol from the lining of the arteries.
MEN: your HDL should be 60 mg/dL or HIGHER (14).
3. Triglycerides.
This is a good marker of carbohydrate intake. Conventional lab ranges consider triglycerides less than 150 mg/dL to be “normal”.
Optimally, triglycerides should be LESS than 100 mg/dL.
However, according to preventative cardiologist Dr. William Davis, author of Wheat Belly, an optimal triglyceride level is even lower: 60 mg/dL or less (15).
4. Blood pressure.
Your blood pressure is a measure of the pressure (force) of blood against the walls of your blood vessels (arteries). A blood pressure reading consists of two numbers. Systolic (top number): Measures the pressure of when your heart contracts and pushes blood through the arteries. Diastolic (bottom number): Measures the pressure of when your heart relaxes between beats.
Optimal blood pressure is 120 / 80 or LESS.
High blood pressure is the #1 risk factor for heart disease and stroke (16).
There are 3 stages of high blood pressure (17).
1) Hypertension, Stage 1: Blood pressure is 130-139 (systolic) / 80-89 mm Hg (diastolic). Lifestyle changes can help mitigate.
2) Hypertension, Stage 2: Blood pressure is 140/90 mm Hg or higher.
3) Hypertensive Crisis: Blood pressure suddenly exceeds 180/120 mm Hg; if you are also experiencing symptoms, such as chest pain, shortness of breath back pain, numbness/weakness, call 911 immediately.
5. Blood sugar (fasting glucose) level.
This is a measure of glucose (sugar) in your blood after fasting at least 8-12 hours. Conventional lab ranges deem “normal” blood sugar as being between 70-99 mg/dL. However…
An optimal fasting blood sugar level is between 70-85 mg/dL.
Being “metabolically healthy” means that you would have optimal levels of all of the above.
What Is Metabolic Syndrome?
Poor metabolic health can lead to “metabolic syndrome”, a group of risk factors that indicate a damaged metabolism, raising your risk of heart disease, stroke and diabetes.
You will be diagnosed with metabolic syndrome if you have 3 or more of the following risk factors:
1. Waist size.
This simple measure—using a tape measure—is reliably accurate. MEN: If your waist circumference is greater than 40 inches (and WOMEN: if your waist size is greater than 35 inches), it is time to rethink your food choices and lifestyle habits.
Waist circumference is a stronger predictor for diabetes risk than BMI (Body Mass Index). A large waist circumference is also strongly associated with coronary heart disease and death from all causes (18).
A big belly is often an obvious indicator of visceral fat, excess fat located in the upper abdominal region. Visceral fat is the type of fat found deep within your abdominal walls and it surrounds important organs, like your stomach, liver and intestines (19).
Having too much visceral fat increases your risk for comorbidity, the presence of more than one disease in your body at the same time (e.g., kidney disease, hypertension and anemia), compared to excess fat located in other areas of your body (20).
2. High blood pressure.
Pay attention if your blood pressure is 130/80 mm Hg or higher.
High blood pressure is strongly associated with obesity and insulin resistance (21). However…because we live in a highly toxic and stressful world today, you can be of “normal” weight and have high blood pressure. Knowing your blood pressure—no matter what your age—is important because consistently elevated blood pressure over a long period of time can damage your heart and blood vessels. High blood pressure can also cause plaque to build up in your arteries, raising risk of heart disease or stroke (22).
3. High-normal fasting blood sugar.
Take note if your fasting blood sugar is higher than 95-100 mg/dL (23).
Consistently high blood sugar can damage your blood vessels, raising your risk of getting blood clots. Blood clots can cause heart and blood vessel diseases, like carotid artery disease and aortic aneurysm (24, 25).
4. High blood triglycerides.
Notice if your triglycerides are higher than 150 mg/dL.
Regularly over-consuming alcohol, food and drink with added sugars, refined carbohydrates, unhealthy fats and processed foods can ramp up triglycerides, a type of fat in the blood. High triglycerides are linked with increased risk of heart disease, metabolic syndrome and pancreatitis (26).
5. Low HDL (“good”) cholesterol.
This is a red flag for MEN: if your HDL is less than 40 mg/dL (and for WOMEN: if your HDL is less than 50 mg/dL).
Low HDL increases the risk of developing heart disease.
Having an optimal level is important because HDL helps soak up excess cholesterol from the walls of blood vessels and carry it to the liver, where it is broken down, then removed from the body in the bile (27).
MEN: What You Can Do
1. Know your numbers.
Getting the right bloodwork can provide you with a snapshot of your current metabolic health status. If your numbers are less than optimal, you can work on lowering—even reversing—your risk for heart disease as well as other chronic health conditions.
Personally, I stay on top of my own metabolic and hormone health by using direct lab testing to order my own lab work every 3 months. A big advantage of using direct lab testing is that I do not have to schedule a doctor’s appointment (which could be months of waiting). I do not have to worry whether 1) the doctor will order the labs I requested; or, 2) whether insurance will cover the labs. When I order my own labs, I know that I will get exactly what I paid for. Although direct lab access is not available in New York and New Jersey, I tell clients that they can go to Connecticut, Pennsylvania or Massachusetts for their direct access lab blood draw. When I order my direct lab tests, I usually travel to Massachusetts for my blood draw. Results are emailed to me within one week. I then typically send a copy of my lab results to the practitioner with whom I am working.
If you would like to get on top of your metabolic health, consider ordering this comprehensive Men’s Metabolic Health Panel. Your appointment for the blood draw can be scheduled at any time.
2. Keep an open mind.
We are gifted with just one body! Be willing to invest time, energy and/or money in seeking support that your health insurance may not cover, whether it’s a naturopath, chiropractor, acupuncturist, functional health practitioner, or a functional health coach, like myself.
Of course, you can always consult a medical doctor. Keep in mind, however, that while doctors can prescribe medications to treat symptoms, they are not trained to give customized, holistic guidance on food choices and lifestyle practices that enable you to be proactive about your health. The focus of conventional medical treatment will be on a specific body part (e.g., heart, kidney, feet) and prescribing a pharmaceutical remedy for a condition.
Even if you take prescription medications for, say, diabetes or a heart condition, you can bolster the efficacy of those medications by making healthy food and lifestyle choices rather than relying only on medications to “take care” of your body.
3. Address food choices.
The foods we choose to eat can nourish us, giving us stable energy, OR they can create inflammation that contributes to disease. Choose whole, unprocessed foods—and organic as much as possible. Eat more home-cooked meals.
4. Engage in regular physical activity.
I’m not talking about training for a marathon or doing CrossFit five or six times a week. If you have been mostly sedentary for a while or traveling a lot for work, start small. Be mindful of walking wherever you can—as much as you can—with an eventual goal of 10,00 steps or more. The overall goal is to be consistent about getting movement within the context of your daily life.
5. Prioritize rest and relaxation.
Working hard AND playing hard can exponentially increase the stress hormone cortisol, making it difficult to lose belly fat—or to lose weight in general. Engaging in pleasurable, stress-lowering activities, like naps, gentle stretching, leisurely walks, massage, hot baths, listening to relaxing music or playing with your pet, can help lower stress hormones.
6. Find time to balance work and family life.
Work can be all-consuming…I get it! But balance is key. Key relationships need nurturing as well. Make time to schedule a date with your wife/partner, time with your children and/or other family members or friends whose relationships you value.
7. Channel stress energy into an activity that you enjoy.
We all need a way to decompress and release stress. Ideally, it will be something that you enjoy. Basketball. Golf. Martial arts. Fishing. Hiking. A wood-working project. Gardening. Building a deck. Life cannot begin and end with work; we also need to include sources of pleasure in our life!
8. Pay attention to how you cope with emotional, physical or mental stress.
Do you pour yourself a drink (wine/cocktail/beer)—or several—as soon as you get home from work? Do you need a few hits of weed to relax and unwind before bed? Do you like to zone out in front of the television, surf online, or scroll through your phone until the wee hours of the morning? Do you shut down and retreat into yourself after a stressful day? Do you feel chronically overwhelmed? Our thoughts, feelings and emotions affect the food and lifestyle choices we make. Consider working with a mental health provider if you struggle with anxiety, depression or other feelings or thoughts that you find challenging to navigate.
Seeking Support from a Functional Health Coach
Our metabolic health affects our quality of life. If your metabolic health is less than optimal, working with a functional health coach can help you improve your metabolic markers.
We will address potential root cause issues—food choices, lifestyle practices, self-talk and physical, emotional and mental stressors—that may be driving your symptoms.
My practice is 100% remote and I meet with clients via video (or phone if preferred) in-state and out-of-state.
Take Action!
1. Want to know the status of your metabolic health? Test…don’t guess. And don’t wait until “later”! Consider direct lab testing and the advantages of getting a comprehensive Men’s Metabolic Health Panel.
2. You can discuss the results with your doctor. Another option: I can also review your labs with you. Click here to learn more.
3. Would family and friends benefit from receiving this free, monthly e-Newsletter? Please share this SIGN UP LINK.
Sources:
1 Thompson, A.E., Anisimowicz, Y., Miedema, B. et al. The influence of gender and other patient characteristics on health care-seeking behavior: a QUALICOPC study. BMC Fam Pract 17, 38 (2016).
2 CDC/National Center for Health Statistics. Aug. 31, 2022.
3 Centers for Disease Control and Prevention. Provisional Mortality Data—US 2022. May 4, 2023
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5 Jortveit J, Pripp AH, Langørgen J, Halvorsen S. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart. 2020 Sep;106(18):1420-1426.
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8 Zhang Z.M., Rautaharju P.M., Prineas R.J, Rodriguez C.J., Loehr L, Rosamond W.D., Couper D., Soliman E.Z. Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. May 31, 2016. Vol. 133. Issue 22.
10 Penn Medicine. Penn Heart and Vascular Blog. Apri 4, 2022.
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18 Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R; Association for Weight Management and Obesity Prevention; NAASO; Obesity Society; American Society for Nutrition; American Diabetes Association. Waist circumference and cardiometabolic risk: a consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care. 2007 Jun;30(6):1647-52.
19 Cleveland Clinic. Visceral fat. 9/12/22.
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22, 24 NIH: National Heart, Lung and Blood Institute. What is Metabolic Syndrome? May 18, 2022.
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25 Cleveland Clinic. Vascular Disease. 3/22/2022.
26 Kaiser Permanente. High Triglycerides. Healthwise. Sept. 7, 2022.
