Men’s Health Handbook
Two top experts in men's health discuss the most common issues guys face as they age—and simple natural solutions to help you avoid them.
Get full access to Outside Learn, our online education hub featuring in-depth nutrition, fitness and adventure courses, and more than 2,000 instructional videos when you sign up for Outside+..
“If it ain’t broke, don’t fix it.”
All too often, such a mentality misleads men into ignoring their health, according to Fred Pescatore, MD, a New York-based integrative physician and author of The Hamptons Diet, The Allergy and Asthma Cure, and other health-related books. However, men who keep themselves in good shape have an excellent chance of staying that way for many years to come.
A study of 2,357 men who had reached the age of 70, published in the Archives of Internal Medicine, found that men have a 54 percent chance of living to age 90 or longer if they don’t smoke or have diabetes, have normal weight and blood pressure, and exercise two to four times a week. “Furthermore,” the authors of this study reported, “men with a life span of 90 or more years also had better physical function, mental well-being, and self-perceived health in late life compared with men who died at a younger age.”
In other words, a healthful lifestyle doesn’t just increase the length of life, but also improves its quality.
What Breaks
A drop in sex drive, less enjoyment from exercise or sports, and inexplicable fatigue are among the most common men’s health issues. “I’m just not as strong as I used to be,” or “I’m not feeling like my usual self,” are frequent complaints. The likely trigger of these symptoms is excess weight around the middle, creating an apple-shaped body.
“Pushing the pants down under the gut is not a good look,” says Pescatore, and he isn’t just referring to faulty fashion sense. “That gut is not healthy,” he says. Internal fat surrounding the organs in the abdominal area actively promotes disease-causing inflammation and brings about insulin resistance, a precursor of diabetes and heart disease.
Insulin delivers blood sugar, or glucose (energy from food), to cells. When insulin resistance exists, the cells refuse to accept that energy, causing high levels of glucose in the blood and more fat storage, which then perpetuates the condition. One of the byproducts is low levels of testosterone. “The more overweight men are, the more testosterone converts to estrogen,” explains Pescatore. And low levels of testosterone make a guy feel less manly.
The Men’s Health Fix
“First, lose weight,” says Pescatore. Food and exercise are the weapons of choice to raise testosterone levels naturally. The food strategy is simple: Combine the diets of two strong wild animals, lions and gorillas. Lions live on meat, while gorillas are almost 100 percent vegetarian. Men do well by borrowing dietary habits from both animals, and adding fish.
Specifically, to increase your own testosterone production, Pescatore recommends skipping sugar, which is plentiful in sodas, ketchup, and other foods you wouldn’t think of as dessert. So reading labels is a must.
Instead, eat lean protein and lots of non-starchy fresh vegetables, preferably ones that are in season and grown locally. (Potatoes and corn are high in starch, whereas dark, leafy greens are not.) Include some legumes and whole grains such as brown rice and quinoa. Many people have a sensitivity to wheat, which can contribute to weight gain and poor digestion. Consider eliminating this grain from your diet for a while and see how you feel. Protein drinks and bars can also be healthful snacks or pre-/post-workout fuel—again, read labels carefully to weed out high-sugar products. Also, be sure to include healthful fats such as olive or macadamia nut oils.
Exercise that gets your heart pumping helps your body make testosterone. Get at least 30 minutes of significant cardiovascular exercise at least four times a week, and do resistance training at least twice a week. When doing cardiovascular exercise, take your pulse to gauge your intensity level and make sure you’re not overexerting yourself. To calculate your maximum heart rate, simply subtract your age from 220. For example, if you’re 45, your maximum heart rate would be 175. For moderate intensity, shoot for 50–70% of your maximum rate, and for vigorous intensity, aim for 70–85% of your maximum heart rate.
Pescatore also recommends a multivitamin and chromium for blood sugar control; fish oil for the heart and overall health; and Pycnogenol, an extract from pine bark, for antioxidant protection, blood sugar control, circulation, and heart health. Alpha-lipoic acid helps fight diabetes, and CoQ10 helps protect the heart. Combined with the amino acid l-arginine, Pycnogenol can also help with erectile dysfunction, according to one study.
Testosterone Levels and Men’s Health
In medical research, testosterone has gained prominence as an indicator of risk for various diseases. A review published in the Journal of the American Heart Association noted that “A growing body of evidence suggests that men with lower levels of endogenous testosterone are more prone to develop CAD (coronary artery disease) during their lifetimes.” And a 2018 study published in Scientific Reports found that not only is low testosterone linked with chronic disease, but it’s more prevalent among the general population—including younger men—than was previously thought. However, this doesn’t mean that testosterone replacement therapy is a quick fix for all potential ills.
Research shows that when natural levels of testosterone are high, men function better, are less prone to disease, and live longer. However, researchers stop short of recommending testosterone replacement therapy because large studies of such therapy have not been done. Given that it took some years for large studies to discover the risks of hormone replacement therapy for women, scientists are reluctant to assume that testosterone therapy will have the same beneficial effects as naturally high testosterone levels. On a positive note, research to date has not identified any hazards of testosterone therapy.
Sleep Apnea and Snoring
A condition that afflicts men much more than women, sleep apnea can elevate blood pressure and leave you feeling tired—even after a long night’s sleep. Signs are loud, irregular snoring with quiet breaks when breathing stops. “It’s as though someone puts a pillow over your face and suffocates you many times a night,” says Jacob Teitelbaum, MD, an integrative physician and author of From Fatigued to Fantastic, Pain Free 1-2-3, and other books.
Excess fat in tissues around the neck is a common underlying cause, says Teitelbaum, in which case the solution is to lose weight. To get better sleep in the meantime, he recommends sleeping on your side, rather than your back. Raising the head of the bed with bricks under the headboard may also help. Large tonsils or adenoids, allergies, and some medications are other possible causes, and the condition may be hereditary. Medical treatment utilizes equipment to aid continual breathing during the night. If you have insomnia, try an herbal approach: Teitelbaum recommends a formula made with valerian, passionflower, Jamaica dogwood, and/or hops.
Is Your Prostate Healthy?
If you’re in your 50s or 60s, you’ve probably experienced benign prostatic hyperplasia (BPH), or an enlarged prostate gland. Symptoms can include frequent urination, difficulty urinating, and inability to sleep without having to urinate at night. Many supplements have shown positive results for easing BPH. Teitelbaum recommends taking 320 mg of saw palmetto in divided doses and 25 mg of zinc (including the amount in your multivitamin) daily.
Flaxseed, red clover, stinging nettle, pumpkin seed, pygeum, lycopene, and selenium are also thought to help promote optimal prostate function.
Supplements for Men’s Health
For health maintenance: Pescatore recommends the following basic supplements for men:
- Daily multivitamin/mineral: with 50 mg B vitamins and 200–400 mg magnesium
- Chromium: 200 mcg daily
- Fish oil: 3 g daily
- Pycnogenol: 25 mg daily
If you have a large gut, diabetes, or other risk factors for the disease, Pescatore suggests trying the following dosages and nutrients in addition to a multivitamin and fish oil:
- Pycnogenol: 50 mg daily
- Chromium: 200 mcg three times daily
- Alpha-lipoic acid: 100 mg three times daily
- CoQ10: 100 mg daily
