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Review Article STEPS TO BETTER HEALTH FOR MEN KIRBY et al. Steps…
Tags: amoroso, better health, cardiovascular disease, cultural beliefs, gap, gender gap, gould, insufficient exercise, john dean, longevity, male patients, men s health, mortality and morbidity, physical behaviour, prostate centre, roger s kirby, type 2 diabetes, unhealthy patterns, urologist, weight exercise,Pages: 4
Language: english
Created: Wed Jun 28 06:43:18 2006
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Review Article
STEPS TO BETTER HEALTH FOR MEN
KIRBY
et al.
Steps by which better overall health for men could
be achieved
ROGER S. KIRBY, MIKE G. KIRBY*, PETER AMOROSO, JOHN DEAN and DUNCAN GOULD
The Prostate Centre, London and *The Surgery, Letchworth, UK
Accepted for publication 2 March 2006
INTRODUCTION world's populations. The UK shows a pattern a programme of exercise and healthy
similar to that first seen in the USA, about nutrition.
Men's health has become an important half of adults in Britain are now estimated
medical, social and political issue. On average, to be at an unhealthy weight [2]. This is
men die 5 years younger than women, and probably the result of cultural beliefs, EXERCISE
some reasons for this `gender gap' are deeply insufficient exercise, combined with an
entrenched and unhealthy patterns of male unbalanced proportion of calories/energy It is now widely accepted that regular physical
behaviour. In this review, we set out ways by consumed vs energy expended. Weight exercise can reduce an individual's age-
which the urologist can interact positively gain can be subtle and insidious, increasing adjusted risk of mortality and morbidity from
with their male patients to increase their gradually over a long time, and is deleterious cardiovascular disease (CVD), hypertension,
longevity and enhance their quality of life [1]. for overall health. stroke, type 2 diabetes, osteoporosis and some
cancers, while often improving lipid profiles
Currently, most men are very reluctant to Obesity is estimated to shorten life by an [47]. Much research suggests that the
make the adjustments that contribute to a average of 9 years, i.e. 2 years more than improvements are greatest, especially for
healthy lifestyle. Too often, they allow prostate cancer. In the UK, 6% of all deaths cardiovascular health, when an individual is
themselves to develop central obesity and can be attributed to obesity. Being overweight exercising at their optimum level. This
thereby lay themselves open to all the increases a man's risk of developing type 2 requires physical exertion of sufficient
features of the metabolic syndrome (Fig. 1). diabetes, high blood pressure, and several intensity to achieve 5085% of one's
They visit the doctor on average only half as cancers (prostate included) as well as likely maximum heart rate, sustained for 30 min/
often as women, and then only when disturbances in lipid levels. It also increases day, for 5 days/week. However, many
symptoms serve as a `wake-up call'. Often, the the likelihood of osteoarthritis of the knees, individuals are very averse even to the
first symptom that encourages them to hips and ankles, back pain and swelling of the thought of such strenuous activity. As any
accept a check-up is urological, e.g. urinary legs. Although many people who are obese exercise is better than none, and the health of
frequency, urgency/flow problems, or consume too many calories, their diet is often today's sedentary adults might be improved
anxieties about sexual, especially erectile, deficient in the nutrients essential for good with relatively low levels of physical activity.
dysfunction (ED). Evaluation may reveal health. A balanced diet includes three regular For some of these men, enthusiasm for
underlying prostate disease, obesity, diabetic meals a day, providing lots of fruit, vegetables, exercise and health improvement can be
tendency and/or hypertension, as well as whole-grains and less saturated fat. Recent achieved simply by incorporating leisure
significant dyslipidaemia. At this stage there studies showed that, in patients aged 7090 activities, e.g. walking, gardening, cycling, or
is a risk that the urinary symptoms and/or ED years, adherence to a Mediterranean-type golf, which can be gradually increased over
might be treated purely symptomatically, with diet and healthy lifestyle lowered all-cause time to include gym work or swimming [8].
an -blocker or phosphodiesterase type 5 and cause-specific mortality by more than Specifically, buying a pedometer and walking
inhibitor, thereby missing a crucial half [3]. 510 000 steps/day can be both inspiring and
opportunity to address the associated risk motivational. In addition to the physical
factors and lifestyle issues. Excessive eating is just one example of benefits, exercise is likely to have positive
conditioning and habituation that could be psychological effects. The recent paper by
All healthcare professionals dealing with men described as an `addiction'. A pharmacological Giovannucci et al. [9], which reported that
on a daily basis, but especially a team which addiction that is much more difficult to break men aged >65 years who engaged in vigorous
focuses on urological health, are well placed is smoking. Hectoring about the hazards of exercise for >3 h/week reduced their risk of
to work with the patient and his partner to smoking is unlikely to result in a durable high-grade, advanced or fatal prostate cancer
increase life-expectancy and enhance quality cessation of the habit. Hypnotherapy can by 70%, might provide the impetus for
of life. Outlined below are some ways by work for some, as can the application of urologists, cardiologists and others to
which this could be achieved. willpower and cognitive techniques. The use emphasize the benefits of exercise to their
of nicotine replacement (skin patches, gum patients.
and inhalants, etc.), used for at least 3 months
HEALTHY EATING AND while cravings abate, is far more likely to
STOPPING SMOKING achieve the results that both the physician SEXUAL HEALTH
and patient desire. Stopping smoking is often
In the past 30 years, the prevalence of weight associated with weight gain, which can be Up to 52% of men aged 4070 years will
gain and obesity has increased in many of the helped by counselling and strict adherence to have experienced some degree of ED [10].
© 2006 THE AUTHORS
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K I R BY ET AL.
International research suggests that ED LDL cholesterol levels should be lowered to DIABETES
affects 20% of men, and in 1995 it was 60 years [16]. The WHO has
way of increasing physical activity, helping to defined a `normal' blood pressure as a systolic Diabetes is currently estimated to cost 9% of
relieve stress and deepen a relationship, and it blood pressure of 15 million deaths per year that the metabolic syndrome might be CONFLICT OF INTEREST
worldwide. The UK has one of the highest associated with hypogonadism in men
rates of CVD in the world. Although the UK is [21], and there is a high prevalence of Dr Duncan Gould undertakes consultancy
behind most other countries in preventing hypogonadism in men with diabetes. Most of work for AstraZeneca.
and treating CHD, numbers are falling, by the differences in testosterone levels between
3000 deaths/year. Common risk factors for men with diabetes and men without diabetes
CVD include an unhealthy diet (high in might be due to low levels of sex-hormone- REFERENCES
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