You don’t need to believe that “men are from Mars, women are from Venus” in order to accept that men and women have different nutritional needs. Men lead in eight of the top ten causes of death in the United States. As is often observed, because men are more reluctant than women to seek medical care, when they do so, their illnesses typically have advanced to a more serious degree. It would seem that men, even more than women, would do well to adopt defensive measures to preserve their health. Women are not only the fairer sex, but when it comes to health, they are in general, also savvier. However, men should not depend on the supplements used by their wives or women friends. Some preventative measures are strictly gender-specific. For example, whereas calcium and iron are good for women, these minerals may not be good supplement choices for men.
For men, the primary health issues today probably are cardiovascular disease and conditions affecting the prostate. Heart disease is the leading cause of death in men and prostate cancer is the seventh. Are matters improving? It is hard to tell. For instance, the incidence rate of prostate cancer went up in the period from 1995 to 2000, although the death rate appeared to have stabilized. Fortunately, the rate of lung cancer continues to decline. As for heart disease, our current emergency medical interventions are so effective that the death rate is declining. However, actual cardiovascular health is not improving—the rate of occurrence of first heart attacks is going up. How could it be otherwise? Obesity, diabetes and hypertension are all increasing. Diabetes in adults males over the age of 20 is estimated to now occur at a rate of 9.3 percent (data for 1999–2000) compared to 7.9 percent in the period from 1988 to 1994. For men aged 60 or over, the rate in 1999–2000 was roughly 19 percent. The following suggestions are designed to help men take charge of their health while the ball is still in their court.
Cardiovascular health is a common topic of conversation. The reason, of course, is that heart disease in its various forms is the leading cause of death in adults and is especially prevalent in males. By age 60, one in five men will have already suffered a heart attack. The conditions to watch usually have been taken to be dysregulated blood lipids, homocysteine levels, hypertension, and obesity. More recently, it has been suggested that chronic low-level inflammation is a major causal factor in cardiovascular disease and that the Metabolic Syndrome (insulin resistance) is the actual underlying condition responsible for many or even most of the risk factors traditionally treated as indicators of heart and circulatory health.
Antioxidants, Essential Fatty Acids and Minerals
So-called “bad” cholesterol, low-density lipoprotein (or LDL), according to much current thinking, is only harmful if it has been damaged by oxygen and/or free radicals. Therefore, a protective program might include vitamin C (500 mg—2 grams daily) taken along with vitamin E as gamma-tocopherol (200 IU daily) and plant antioxidants. Tocotrienols, compounds from the same family as vitamin E, may be even more protective. A spate of studies have shown that the beneficial effects of vitamin E are much more pronounced in the gammatocopherol form and that vitamin E should not be supplemented alone, but rather in conjunction with vitamin C and the other antioxidants mentioned here. Indeed, many researchers now believe that the vitamin antioxidants are much more effective if used together and along with a variety of plant-derived antioxidants.
Grape seed extract (100–300 mg daily) is commonly used in Europe by individuals who experience vascular and general circulatory problems. According to epidemiological data, safe and effective means of reducing heart disease risks include the ingestion of many such flavonoids, catechins and other polyphenols found in fruit extracts and tea. With regard to tea, these benefits come not just from green tea, but also from the theaflavins found in black and oolong teas. Another set of plant compounds that support heart health are lignans. Flax is especially rich in lignans. Tea, of course, is a beverage and flax is a food. Other food sources being mined for special antioxidants include olives and various highly colored berries.
Similarly useful nutrients include the combination of L-carnitine (500–1,500 mg daily) and coenzyme Q-10 (30– 300 mg daily). Specialty forms of L-carnitine include L-carnitine fumarate, GPLC (glycine propionyl L-carnitine hydrochloride) and acetyl L-carnitine. Alpha-Lipoic acid (100–300 mg daily) is another good choice, and one with a particularly broad range of benefits. Minerals to supplement are chromium (200–600 mcg daily), magnesium (400 mg daily, preferably as magnesium aspartate) and selenium (200 mcg daily). A good broad-spectrum mineral supplement containing the Reference Daily Intake of copper should be considered if using the higher recommendation of vitamin C or if elevated triglycerides are a problem. Emerging evidence also supports supplementation with the lesser-known mineral silicon in the form of orthosilicic acid.
Of great importance, for instance, in controlling inflammation, is the right balance of fats in the diet. It is accepted by most researchers that the modern Western diet is very poor in the essential fats known as omega-3 fatty acids. Sources of omega-3 fatty acids are flaxseed oil (1–2 tablespoons daily) and fish oil capsules (follow manufacturers’ recommendations). Just how important are these oils? Well, when the fish-supplemented trials are removed from statistical analyses of the standard low-fat dietary interventions routinely touted in medical circles, the benefits with regard to heart disease are marginal and overall mortality rates actually increase! Gamma-linolenic acid (GLA, 100–300 mg daily) can be taken in conjunction with omega-3 fatty acids for further protection against inflammation and to maintain immune balance when large amounts of fish oils are ingested. Finally, to protect against elevated blood homocysteine levels, supplement with vitamin B-6 (15–50 mg daily), vitamin B-12 (250 mcg daily) and folic acid (400 mcg daily).
What can go wrong with the prostate? Plenty. Prostate problems typically can be catalogued under four headings: prostatitis, prostatodynia, benign prostatic hyperplasia (BPH), and prostate cancer. Prostatitis is really a catch-all term for several types of prostate problems. It always involves inflammation of the prostate and may also include considerable pain, whereas BPH may not involve any pain (as opposed to discomfort). Prostatitis is fairly common in adult males. It sometimes has a bacterial infectious component, but it often has no clear cause. Abstaining from alcohol and spicy foods helps in some cases. Prostatodynia, which is most common in young and middle-aged men, often appears as pain and/or discomfort in the groin, perineum, testicles, lower back, and penis. Smooth muscle spasms in the prostatic portion of the urethra and in the neck of the bladder are at work here. Fatigue in the muscles in the pelvic region and emotional stress appear to be powerful contributory factors in prostatodynia.
Benign prostatic hyperplasia (formerly called hypertrophy) involves the renewed growth in the number of prostate cells late in life. Unfortunately, nearly 60 percent of men age 40 to 59 are likely already to suffer from BPH. This usually does not present a noticeable problem until after age 50, but by the age of 80, some 85 percent of all men suffer from one or more symptoms of BPH. The primary effect of BPH is a progressive decrease in the ability to empty the bladder as the prostate enlarges and applies pressure to the urethra. BPH should not be confused with prostate cancer,although there is an overlap of symptoms between the two. Men over age 50 should regularly visit their urologists to discover and distinguish between these two conditions. Fortunately, prostate cancer is one of the slowest growing of all cancers. Antioxidants, Essential Fatty Acids and Minerals
Prostate problems are far easier to prevent than to deal with after they have manifested. Moreover, especially in the case of prostate cancer, epidemiological studies routinely find that eating more fruit and vegetables is strongly protective, whereas consuming large amounts of milk (especially more than two glasses per day) appears to have a strongly negative effect upon prostate health. Studies suggest that supplementing with vitamin E (200 IU daily), lycopene (5–10 mg daily), and the minerals selenium (400 mcg daily) and zinc (15 mg daily) are good protective measures. Flaxseed oil (1–2 tablespoons daily) can be quite beneficial, as can the regular consumption of pumpkin seeds. Men should avoid margarine, hydrogenated vegetable oils and fried foods whenever possible. The jury is still out with regard to the effects of calcium supplementation in men. Some epidemiological studies indicate that higher intakes of calcium are correlated to higher risks of prostate cancer, perhaps through a negative effect upon the levels of active vitamin D in the body or through some other mechanism. The work of E. Giovannucci of Harvard Medical School has been instrumental in uncovering the calcium/prostate cancer connection and the protective effects of fruit consumption nd an adequate intake of vitamin D (but not more than 400 IU daily).
Isoflavone Herbal Preparations
Although it may surprise most men, many of the same isoflavones and phytoestrogens that are helpful to women are also helpful to men. Men and women both produce estrogen. As males age the ratio of testosterone to estrogen is reduced. This reduced ratio of testosterone to estrogen appears to be the key cause of prostate problems. Plant estrogens, which are very weak in comparison with the estrogen itself, can actually reduce the impact of hormonal estrogen at the level of cell receptors. Isoflavones found in soybeans and red clover represent a promising approach to prostate health management. Also useful are extracts of saw palmetto berries and flower pollen. Indeed, specialty flower pollen extracts (from mostly rye pollen) have an unusually broad range of benefits for the prostate in that they have proven to be useful not only in cases of BPH, but also in prostatitis and prostatodynia.
Prolonged stress poses a very real health risk, one with which men are less physiologically equipped to cope than are women. Higher rates of heart disease and high blood pressure are but two results. In the pre-modern world, many or even most threatening or challenging situations (“fight or flight” situations) led to a physical response which consumed and directed the energy made available by the release of hormones such as epinephrine into the blood stream. Physical responses, however, are not usually possible or even desirable in the face of stalled traffic or office frustrations. In such cases, the released energy is “bottled up,” as it were. This results in disturbances in sleep, immune function, blood pressure regulation and other bodily systems. As the “fight or flight” reference suggests, the best responses to stress are often physical. Try to get some vigorous physical exercise every day, but also consider practicing yoga or some similar form of relaxing physical therapy.
Nutrients and Herbs for Relaxation
Generalized emotional and physical stress leads to oxidative stress. Therefore, a broad-spectrum antioxidant mixture is an excellent countermeasure. Be sure to include in the diet, as well, the recommended daily intake of all of the B vitamins. The amino acids taurine (500 mg to 1 gram daily) and glutamine (750 mg to several grams daily) play important roles in the body’s response to stress. These are best utilized if taken between meals with a small carbohydrate snack. The bioflavonoid known as chrysin (1–3 grams daily) is an important stress-reducing compound, as are theaflavin, valerian and skullcap (see manufacturers’ directions). Also useful are calming herbal teas. The best known of these is chamomile.
Sports Aches and Pains of the Weekend Warrior
Exercise is important. In some studies, men who exercised regularly had a 70 percent reduced risk of death from all causes and a 39 percent reduced risk of death from heart attack. This is the good news. The bad news is that those of us who are sedentary for five days out of the week and then try to make up for this in the remaining two days of the weekend may find that we end up with more than our share of aches and pains. The body responds best to regular exercise, which is to say, exercise at least every other day. Cramming a week’s worth of exercise into the weekend is asking for trouble. And, of course, as we get older our ability to “bounce back” from strenuous physical exertion diminishes. Fortunately, there are some ways to prevent problems and to help make them go away once they develop.
Conditioned athletes are actually able to produce more of certain antioxidant enzymes within their bodies to cope with this heightened demand, and this fact indicates that training may produce a type of “reserve capacity” for antioxidants. However, it is still true that exercise puts oxidative stress on the body. In various studies, athletes who ingested an antioxidant “cocktail” before working out experienced faster recovery and fewer aches and pains than those who did not take the antioxidants. The daily antioxidant intake might include vitamin C (500 mg–2 grams), vitamin E (100–200 IU as gammatocopherol), coenzyme Q-10 (30–300 mg), alpha-lipoic acid (100–300 mg), plus a number of plant antioxidants, such as mixed citrus bioflavonoids (1,000–3,000 mg). Individuals who are involved in contact sports might consider either grape seed or pine bark extracts (200–300 mg) to help prevent bruising. Glutamine (750 mg to several grams daily) recently has become one of the favored supplements by serious athletes because of its benefits in recovery and in sparing the destruction of lean tissues due to excessive exertion.
Nutrients for Repair
Ligament and cartilage injuries are common in sports. Glucosamine and chondroitin sulfate are often recommended in osteoarthritis to improve the repair of cartilage, and these compounds can also be used to speed up repair—or to improve general resilience—of the joints, ligaments and tendons in sports. (Follow manufacturers’ directions.) Sadenosylmethionine (SAMe) is another nutrient that improves tissue repair and indirectly reduces pain and inflammation; the dosage is typically 400–800 mg of SAMe per day. Expect to wait from one to four weeks to experience the benefits of these supplements if you are just starting to use them. These items improve the body’s ability to heal itself and are not directed at symptoms as such.
Roughly one half of the men in Western industrialized countries suffer from Male Pattern Baldness (MPB), and this syndrome accounts for some 90 percent of all cases of hair loss. However, the presence of MPB does not mean that other factors are not at work, such as reduced circulation. For instance, increases in hair loss in certain areas of the scalp correlate with the development of heart disease. For example, extreme thinning specifically on top of the head (rather than merely receding from the front) appears to be more strongly associated with circulatory disease than is balding elsewhere on the head. Hence, this problem is not always cosmetic and concern may not be limited to vanity.
Deficiencies in the B vitamins biotin, inositol, pantothenic acid, and PABA are particularly linked to hair loss and to premature graying. A number of nutritionists have suggested that high-potency supplementation with the entire range of B vitamins, with special attention paid to biotin, inositol and pantothenic acid, may prove to be helpful. Vitamin C (1–2 grams daily) is important for the circulation, but also for the production of collagen, a component of the hair. Coenzyme Q-10 (30–300 mg daily) is another antioxidant often suggested to improve scalp circulation. Alpha-lipoic acid (100–300 mg daily) similarly appears to be effective and seems to be useful in hair loss if supplemented for at least six months. The amino acid cysteine (1–3 grams daily), also supplemented as Nacetyl-cysteine (NAC, 500–750 mg daily), can help to increase the speed at which the hair grows. A new and really interesting item that improves the quality of the hair is choline-stabilized orthosilicic acid (BioSil)—it is worth a shot. No major improvements in scalp health or hair loss should be expected in less than three months’ time (the hair follicles need to be activated and the hair must grow out). For many men, increasing protein in the diet may also prove useful in increasing the rate at which the hair grows. This may reflect an effect upon thyroid function, in which case, adding omega-3 fatty acids to the diet is also a good idea.
Men’s nutritional needs differ from those of women. It is not difficult however, to meet these special needs. A well-structured program of nutritional insurance should include as a foundation a balanced multivitamin/mineral supplement. Then plan in advance to provide nutritional support for any special needs. As always, it is recommend that you tell your doctor or health care provider what supplements or herbs you are taking. Even if he or she is not overly familiar with them, this knowledge is useful for monitoring your health.
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Dallas Clouatre, PhD
Dallas Clouatre, Ph.D. earned his A.B. from Stanford and his Ph.D. from the University of California at Berkeley. A Fellow of the American College of Nutrition, he is a prominent industry consultant in the US, Europe, and Asia, and is a sought-after speaker and spokesperson. He is the author of numerous books. Recent publications include "Tocotrienols in Vitamin E: Hype or Science?" and "Vitamin E – Natural vs. Synthetic" in Tocotrienols: Vitamin E Beyond Tocopherols (2008), "Grape Seed Extract" in the Encyclopedia Of Dietary Supplements (2005), "Kava Kava: Examining New Reports of Toxicity" in Toxicology Letters (2004) and Anti-Fat Nutrients (4th edition).