At Lifetime Internal Medicine, we want everyone to live their best selves, and we are always here to help and support our patients. In this blog dedicated to Men’s Health, we want to share some practical tips, advice, and resources to support the amazing men in our lives!
The average man’s life expectancy in the U.S. is less than that of a woman, and many conditions to include heart disease, cardiovascular disease, and some cancers can potentially be prevented. Other chronic conditions can be managed through lifestyle modifications, testing, and early interventions. For these reasons, regular doctor’s visits (even when you are feeling well), are so important. Learning about what diseases run in your family is valuable to share with your doctor. Discussing unique concerns, men’s health specific questions, and mental health symptoms are also important. We want everyone to have their annual physicals and to keep their vaccinations up to date. Scheduling follow-up visits regularly throughout the year are great opportunities to stay motivated, focused, and proactive on your health.
What do you recommend for balanced nutrition?
Fruits and vegetables – healthy eating not only provides the essential nutrients and vitamins for energy but can also help manage your weight and reduce your risk for chronic diseases (like diabetes, obesity, metabolic syndrome, and some cancers). Adding more fruits and vegetables is an excellent way to start. The summer season means a variety of fresh produce are more readily available. Frozen produce also packs in all the nutrients and are excellent, affordable choices. If you purchase canned goods, make sure to choose the low salt options. Eating whole fruit is better than drinking fruit juices, and if you do choose fruit juice, make sure to pick 100% juice without added sugars. Dark, green, leafy vegetables, broccoli, peppers, sweet potatoes, avocados, blueberries, bananas, oranges, cherries, and apples are fantastic choices.
Limit foods that are highly processed and those that contain too much sugar, salt, fat, and calories. Whole grains are healthier than refined grains and foods that contain refined flours (like cookies, cakes, and certain snacks). Whole grains include foods like brown rice, whole wheat, oatmeal, buckwheat, whole grain cornmeal, etc. Avoid or limit foods that contain high fructose corn syrup, brown or white sugars, honey, or artificial sweeteners.
Protein – Eat a variety of lean proteins to include fish (esp salmon and tuna), eggs, and poultry (no skin.) Limit or avoid red meat. Nuts, soy, seeds, legumes (beans, peas, lentils) are excellent sources of protein and are very affordable.
Healthy oils are those that contain monounsaturated and polyunsaturated fats and are liquid at room temperature. Good choices for oils include olive, canola, vegetable oils, peanut, vegetable, and avocado oils. Saturated fats are associated with elevated low-density lipoprotein cholesterol (LDL) which is linked to heart disease and death, and are found in foods like red meat, poultry with skin, butter, cheese, etc. Trans fats too are found in many processed foods and are not healthy, as they are associated with an increased risk for cardiovascular disease.
How much exercise should I get?
It is vitally important that we continue to stay as active as possible, especially as we get older. Regular exercise helps with our muscle strength, endurance, stamina, flexibility, and balance. It is also great for our mental health and memory, and improves our heart health. We recommend a goal of at least 150 min of moderate intensity aerobic exercise (like brisk walking) and muscle strengthening 2-3 times a week (free weights or weight machines.). Finding physical activities you enjoy can help you stay motivated, and can involve family members and friends too! If you haven’t been active though or have questions about starting an exercise routine, please make sure to make an appointment with us to discuss starting off safely.
Is it too late to quit smoking?
I
f you smoke, quitting may be the most important thing you do for your health. Smoking is the main cause for lung cancer and chronic obstructive pulmonary disease (COPD), and can significantly increase your risk for heart disease. The CDC offers great resources if you are struggling to quit and need additional help, and we are happy to work together on a plan.
How much alcohol is safe for me to drink?
For men up until the age of 65, healthy amounts of drinking equates to no more than 2 drinks a day. As we age, we become more sensitive to the effects of alcohol and alcohol may not be metabolized as quickly as when we were younger. In addition, alcohol can potentially interact with prescribed and over-the-counter medications. For that reason, men over age 65 should limit their alcohol consumption to no more than 1 drink a day. One standard drink is 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor. If you or a loved one are struggling with alcohol use or want to learn more, please book a visit with us to discuss and check out this handy resource.
What about my weight?
Maintaining a healthy weight is very important for our overall health and for preventing and controlling many chronic conditions such as type 2 diabetes, heart disease, and certain cancers. Losing weight isn’t easy, but we can work together to establish healthy eating patterns and habits, ensure regular physical activity, and review your health and adjust medications.
How much sleep should I get?
Aim for 7-9 hours of sleep a night. As we age, our sleep may become more disrupted and we may not cycle through deep sleep as well as when we were younger. If you would like to discuss more on your individual sleep and feeling more refreshed, please book a visit with us. The CDC and the National Sleep Foundation have some good tips to get started.
How often should I see my doctor?
We welcome you to come in to see us regularly to have your blood pressure and vitals monitored, monitor labs like cholesterol and screening for diabetes, discuss age-appropriate and risk factor appropriate cancer screenings (like colon, prostate, and possibly lung cancer screening based on smoking history), and other screening tests that may be recommended (like ultrasound for abdominal aortic aneurysm, bone density screening, cardiac testing, etc.) Your mental health too is very important, so if you are feeling down, sad, worried, stressed, or anxious, we also want to talk! Of course, whatever other topic is on your mind and has you concerned, we want to discuss.
Sexual health
Let’s face it. Our sexual health is not something that most of us discuss openly with family, friends, and even our partners. But sexual health is an important part of our overall health, and having those conversations with your doctor is important. If you have started to notice any changes or have concerns with libido and erectile dysfunction (which are common), please make sure to have this open conversation with your doctor. There are potential health conditions that can be related and treated (high blood pressure, diabetes, atherosclerosis, endocrine disorder, mental health condition, medication side effects, or related to smoking, alcohol, or illegal drugs.) There are also commonly prescribed medications that can help erectile dysfunction and are effective.
Hair loss
This is called male androgenetic andropecia and is very common, but may be embarrassing and make us more self conscious of our looks. It can start as early as our 20s in men, but usually by 50, most men have some degree of this. It is related to both hormones and genes and often starts as a receding hairline or thinning on the crown of the skull. There is no cure, but there are treatment options which can reduce further hair loss and help men grow some hair. FDA approved medications include topical minoxidil that you apply to your scalp. Oral minoxidil is not FDA approved for hair loss but low doses have been found effective in treating both male and female pattern hair loss. This is by prescription only and requires monitoring, but may be an option for some patients. Oral finasteride is FDA approved to treat male pattern baldness and also by prescription only. It is an anti-androgen medication and decreases the body’s ability to make DHT hormone (dihydrotestosterone) that is linked to hair loss. Other treatments for some patients include hair transplant or PRP (plasma rich plasma injections), and done through a dermatologist. Please book a visit if hair loss is a concern to you and want to talk through other options.
What cancer screenings should men consider?
- Colorectal cancer – there are varied options for screening that each have their own advantages and disadvantages. Current options include direct visualization tests or stool based tests for average risk men that starts at age 45. There are some tests that may be better for a patient over other tests due to individual preference or tolerance, or their individual symptoms or family risks (and may recommend early screening.) We can help have that detailed discussion with you and help arrange any testing and specialty referrals.
- Prostate cancer – According to the U.S. Preventive Service Task Force guidelines from 2018, for men ages 55-69, screening for prostate cancer in average risk men without symptoms should be an individual decision. Did you know that the digital rectal exam is no longer recommended to screen for prostate cancer? For men at average risk, screening with PSA testing (prostate-specific antigen blood test) offers only a small potential benefit of reduction of death from prostate cancer detection, and more men will experience potential harms to include false positive results leading to additional testing, procedures, and treatments which can have complications (incontinence and erectile dysfunction.) Screening for average risk men over the age of 70 is not routinely recommended. However, men who are at higher risk for prostate cancer, particularly those who are African-American and/or have a family history of prostate cancer, may benefit from screening and at earlier ages. Having these discussions with your physician is important to determine the pros / cons of testing and to take into account a man’s individual health, family history, and preferences. This discussion should be re-evaluated periodically.
- Lung cancer – we can screen for lung cancer with a low dose computed tomography scan annually for those patients who have a history of smoking tobacco (with guidelines for a certain quantity of cigarettes and duration of smoking, as well as age of the patient.). We can talk about that at our appointment to see if you qualify and if that is recommended.
- Skin cancer – the USPSTF doesn’t make a formal recommendation on skin cancer screening, although regular skin checks by your primary care physician or dermatologist may be helpful to detect early changes in your moles or other skin conditions related to sun damage.
So, how do I get started?
- If you haven’t had a recent exam or physical, that is the first step. Book an exam with the team so we can review your overall health, preventive health, and specific concerns and questions.
- Set specific and attainable goals. We will work together to devise a plan that works for you so that you can be the best you! It is never too late to start, and small changes now can add up and pay off in huge ways in the future. Let’s take action now to improve your health and wellness.
We look forward to seeing you in the office soon!
Julia Lim, MD, MPH, and your team at Lifetime Internal Medicine
REFERENCES:
Clevelandclinic.org
Myplate.gov
Nutrition.gov
Familydoctor.org
Menshealthnetwork.org
US Preventive Services Taskforce
CDC.gov
Aad.org