Live Long and Prosper

From Menletter June 2002

By Tim Baehr

Live Long and Prosper

The Vulcan blessing from Mr. Spock, "Live long and prosper," is something we could wish for everyone. We could think of it as "Live long and keep your health." What are the challenges to our longevity and overall health?

First, let's acknowledge that there are challenges, and that many of them are male-specific challenges. In the US, men's life expectancy is about 6 years shorter than that of women. Violence is a leading cause of death among young men. Prostate cancer will be diagnosed in about 189,000 men this year and will kill about 31,000. (These figures, by the way, are very similar to the figures for breast cancer, with an annual diagnosis rate of 180,000 and death rate of 41,000.) Some challenges affect both men and women; for example, we seem to be in the midst of an obesity crisis, with corresponding increases in type 2 diabetes, heart disease, and so on. Even within this crisis, however, are some male-specific problems: men tend to pack on weight around the beltline (as opposed to the hips); fat at this location puts an extra strain on the heart.

Do you follow the stereotype of men who don't pay attention to their health? When's the last time you had a physical? Do you even have a regular physician? I know, it's easy to sneer at the people, especially women, who seem to be obsessed about their health. But this isn't about women; it's about us.

Don't Let Your Prostate Leave You Prostrate

Prostate cancer will hit one in six men (compare with the one-in-nine figure for breast cancer). Other than raise awareness by finding a new color of ribbon to wear, what can we do? Three are two main lines of defense: testing and life style.

The two tests for prostate cancer are the digital rectal exam (DRE) and a blood test for prostate-specific antigen (PSA test). What can a doctor find out by sticking a rubber-gloved finger up your ass? The part of the prostate closest to your poop chute may be noticeably harder or irregularly shaped if you have cancer. Your prostate produces PSA throughout your life, and an abnormally high level could signal the beginnings of cancer. If the doctor finds anything worrisome, you'll have a biopsy - tiny pieces of prostate are cut out and examined under a microscope.

Treatments for prostate cancer range from surgical removal to "seeding" the prostate with tiny radioactive pellets. Surgical removal is scary; it knocks you out for several weeks and may leave you temporarily or permanently impotent. If you get to this scary point, ask your doctor about special surgical techniques (one involves borrowing a nerve from your ankle) that preserve potency. And there's always Viagra.

Life style changes can delay or prevent prostate cancer. Here are a few:

1. Lose weight. (I'll get to the obesity challenge in a minute.)

2. Eat tomatoes and foods with tomato sauce. One study showed a 23 percent lower risk of prostate cancer with two servings of tomato sauce a week.

3. Eat foods with selenium.

4. Avoid overdoing zinc supplements.

5. Move your butt. Lack of exercise is implicated in increased risk of a lot of things, including prostate cancer.

Fat or Phat?

Maybe you haven't heard, or haven't wanted to hear: We're fat. About half our nation is overweight and many are obese. The problem is growing (so to speak). Many things have been blamed: television is cited as a major culprit (couch potatoes don't exercise much, and they're subjected to a barrage of snack food ads). Snack and "junk" food itself is blamed; one lawyer even predicts that there could be class-action suits against junk food makers, patterned after the tobacco suits. And then there's a lot of tsk-tsk-ing as if we've somehow lost our moral compass.

Why should this be important to men? One of the most important reasons is that we tend to gain weight around the gut. Carrying fat at the beltline generates all sorts of problems by generating chemicals that can lead to diabetes, heart disease, and about 37 other diseases.

What to do? If you're happy with the way you look and feel, maybe you should resist the "thin is beautiful" media hype, and the stereotype of the hunky, not chunky, male. Life's too short to be fussing over a diet. And if life's a bit shorter on account of the fat, at least you will have enjoyed yourself.

If you're not happy (c'mon, be honest), and it's not because the media has laid a trip on you, then it might be time to do something. Your heart, kidneys, feet, back, knees, and other parts of you will thank you - not to mention your bed partner or your kids, who'd like to have you around for a while.

First, take stock. Go to www.nhlbisupport.com/bmi and calculate your BMI, or Body Mass Index. Over 25, and you're fat; over 30, and you're obese. (What's the difference? If you're fat, you're 16% more likely to die of a first heart attack. If you're obese, the number jumps to 49%. Other potential disasters have similar spreads.)

Second, make a plan. Since you're in this for the long haul (otherwise, why bother?), avoid the fad diets. Or find someone who's been on Atkins, Pritikin, or the all-grapefruit diet successfully for more than a year and follow his plan. Bet you won't find one.

What works? The Men's Health Belly Off Club (www.menshealth.com) seems to make sense. Weight Watchers has a longer track record and a long-term maintenance plan, and it involves eating just about anything you like. Over the years, Weight Watchers has simplified its system tremendously. You no longer have to balance out foods from certain categories every day. You do, however, have to be willing to sit in a weekly meeting with (most likely) a bunch of chubby women talking about water gain and PMS before their periods. Some centers do have men-only meetings; check around. There's also a no-meeting Internet package (www.weightwatchers.com). Plan on losing no more than a couple pounds a week; any faster and your metabolism could slow down, thinking your body is in starvation mode (it is!).

Hint: One secret of Weight Watchers is that you write everything down that you eat. One study I remember showed that this simple act alone led to weight loss.

It's very hard to lose and control weight by exercise alone, especially after middle-age. But exercise is a valuable component of both weight control and a healthy lifestyle. It doesn't much matter what you do; the main thing is to find something you're likely to stick with. Extreme sports, for instance: can you see yourself doing them at 60 or beyond? Could be, but assess carefully. There's nothing wrong with going from one demanding thing to another as you get bored; but be sure you have something to go to. There's also nothing wrong with lowering your activity level as you age or if you become injured. But you'll have to adjust your food intake to match.

You don't need tons of exercise. A daily 20-minute walk may do the trick. The idea is not so much to burn off calories as it is to tone up muscles, increase overall metabolism, and improve your mood. Add some strength exercise (weights, isometrics, etc.) and you'll feel even better.

Hint: Guess what. If you mark exercise on a calendar each time you do it, you're far more likely to stick with a plan. Just like writing down what you eat.

Some good news: Losing as little as 10 percent of your body weight - even if you don't get thin - has significant benefits to heart, kidney, liver, and other functions. Starting with a 10 percent goal is often less daunting than, say, having to lose 30 or 40 pounds.

Why do all this? Here are some side effects from my losing about 35 pounds: Better sleep - pain-free feet - no heartburn - better sex - more energy - lower resting heart rate (80 to 60) - lower cholesterol (220 to under 200). And, ironically, more satisfaction from food. (Full disclosure: My real reason was ego-driven vanity, not health concerns. Whatever works.)

Here's a more cosmic reason: Doing anything with conscious intention may have wider effects in how you approach other life challenges.

Finally, this thought: If you're larger than life and like it that way, and if you and your doctor think you're healthy, then think twice about buying into this whole diet thing. I once knew a young man who was somewhat roly-poly but who moved gracefully and was extremely athletic. I wouldn't have been surprised if he was basically happy with himself and in great health overall.

Source: Much of the data from this article is from the July/August 2002 issue of Men's Health Magazine. Well worth reading.