On the Issue of Men’s Health

I always feel a bit undemocratic when discussing the heath concerns of a particular group, even so large a group as men, given the amount of disease and pestilence affecting us all. But men do have reason for concern as demonstrated by the following fact:

Of the 15 leading causes of death, men have higher mortality rate from every single one of them. Men have a disproportionate risk of death from heart disease to suicide, from cancer to tuberculosis.

Interestingly, men’s health in the medical literature is concerned with diseases of the genitalia and testosterone. Men’s heath in the popular culture has embraced a much larger definition, largely been shaped by publications like Men’s Health Magazine. This is published in 44 languages and distributed world-wide; that’s a lot of influence. Men’s health here is concerned with fitness, nutrition, male specific disease and disparate risk of disease, sexuality and the celebration of youth.

Men lose 0.5 to 1% of their skeletal muscle every year after age 25. Your only salvation is exercise. Fitness in men’s health is strength and muscle development, think the Old Spice advertisement. Jack Lalanne (1914-2011) is considered the godfather of fitness. The story goes in a body building contest: when he was 54, Jack beat Arnold Schwarzenegger (who was 21 at the time). Arnold quipped that “Jack Lalanne’s an animal.” Higher praise does not exist in Arnold’s vocabulary. Strength building is based on the following simple principal. Exercise a muscle to exhaustion (fatigue), rest, and repeat. The damage done to the muscle forces it to rebuild bigger and stronger.

Muscle strength is associated with quality, not quantity, of life. Hard spent hours in the weight room won’t make you live much longer, but you will live better. We are not talking about the attention given to quality biceps here. We are talking about function and ability. For example, elderly men in wheelchairs, sometimes for years, were put on strength training program. Much to everyone’s surprise, a serious (coached) physical strengthening program can actually give these men the ability to walk again. Throwing away the wheelchair must feel almost miraculous. How much better is your life when you can park the wheelchair and take care of yourself? Loss of strength is a common result of any number of diseases and the disability may be as much the weakness as the disease. The weakness can be improved with strength training.

Aerobic exercise is what makes you live longer.

The accepted ideal goal is to exercise 3-5 times per week for 20-60 minutes at an intensity achieving a heart rate of 65-90% of maximum (220 minus your age). Regular aerobic exercise has been proven to prevent and treat hypertension, obesity, coronary artery disease, hyperlipidemia, type 2 diabetes, insomnia and depression. The World Health Organization (WHO) estimates lack of exercise is responsible for 17% of the heart disease, 10% of the colon and breast cancer, and 12% of falls (weak legs) experienced.

As to the disparate risk of death, we need a book, not an essay to approach this in any reasonable way.

In short, start by looking for the common element in this list of the 15 leading causes of death. The one that immediately comes to mind is blood vessel disease in at least half of the list. That we can work with. Most of what goes into blood vessel disease is under our control. Blood pressure, cholesterol, weight, diet, exercise, stress and smoking are under your control. Can’t do much about family history, but you can add a glass of red wine.

Ultimately, men’s health is a subset of human heath. Many of the same life style decisions plague humans of all sexes. These decisions stand between taking control of your health and going along for the ride. Men, it would seem, are particularly suited to taking control of their health.

Take care
Dr B (aka Dr Don Bucklin).

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