Men hate to go to the doctor. I know this because I am one. Here’s what I can’t stand about close encounters of the medical kind: the poking and prodding, the ice-cold stethoscope, the dreaded digital-rectal exam, the blood tests, and dealing with my HMO, whose bureaucracy makes the Pentagon look like a model of efficiency. All my buddies feel the same way—even those who are doctors.
My friends and I are not unusual. Studies show that, except in emergencies, men usually go to the doctor for only one reason—because a woman sends them. That’s mainly why men enjoy a “marriage health bonus”. Compared with single folks, married people live significantly longer and healthier, and the effect is most pronounced for men. It’s not just because men stop eating cold pizza for breakfast. It’s also because women are the family caretakers and, with the exchange of vows, they get new clients—their husbands.
That makes things tough for us guys. After the nuptials, we not only have to dodge the doctor’s appointment clerk who calls to say it’s time for another fun-filled prostate check. We also have to duck the wife, who can’t seem to get enough of our cholesterol counts.
But after years as an intrepid medical journalist, I’ve come up with The Answer: Just stay healthy. This may sound flip, but it’s not all that difficult. The key ingredients to a successful health regimen are: stop smoking, get regular exercise, sleep at least seven hours a night, manage your stress, always remember your anniversary, and embrace plants and herbs.
The best diet for men (and women)
For optimal health, a plant-based diet is definitely the way to go. It helps prevent three of the nation’s leading killers of both men and women: heart disease, cancer, and stroke, which together account for almost two-thirds of U.S. deaths.
What does a plant-based diet have to offer? A lot. Here’s just a tiny fraction of the compelling evidence:
• New Zealand researchers recently compared the health of 6,115 vegetarians with 5,015 meat-eaters. After eliminating other risk factors for heart disease and cancer, such as smoking, the meat-eaters were 28 percent more likely to suffer from heart disease and 39 percent more likely to develop cancer.
• In a study comparing meat-eaters with 25,000 Seventh Day Adventists, whose religion requires vegetarianism, researchers at Loma Linda University in Southern California discovered that the Adventists suffered 40 percent fewer heart attacks.
• Compared with those who rarely eat meat, daily meat consumption more than doubles the risk of stroke. In 1985, John Lynch, M.D., a Yale neurologist, began observing 6,500 stroke-free men. By 1995, 5.4 percent of those who ate meat one to three times a week had suffered strokes—compared with 12 percent of those who ate meat daily.
Meanwhile, as fruit, vegetable, bean, and whole-grain consumption increases, risk of the “Big Three” killers declines considerably:
• Using data from their ongoing Male Health Professionals study of more than 50,000 middle-aged men, Harvard researchers recently discovered that the men who ate the most fruits and vegetables suffered 41 percent fewer heart attacks compared with those who ate the least.
• Gladys Block, Ph.D., a professor of epidemiology and nutrition at the University of California, Berkeley, School of Public Health, reviewed studies correlating diet and cancer risk. Of 156 reports, 128 showed that as fruit and vegetable consumption increased, cancer risk decreased significantly; the other 28 studies showed a clear trend in the same direction. Compared with those who consumed the most fruits and vegetables, those who ate the least had twice the cancer risk.
• Harvard researcher Matthew Gillman, M.D., investigated stroke risk among 832 men using diet information first collected in 1969. Twenty years later the results indicate that, for each daily serving of fruit or vegetables the men ate, their stroke risk decreased 7 percent. The men who ate the most fruits and vegetables had 59 percent fewer strokes compared with those who ate the least.
“But I like meat,” you say. “I don’t want to stop eating it.” The good news is that you don’t have to.
“The best, most manageable diet for overall health is ‘near-vegetarian,’” says Marion Nestle, Ph.D., professor and chair of the Department of Nutrition and Food Studies at New York University. “One three-ounce serving of meat a day probably won’t hurt. The problem is that Americans eat much more than that—an average of six ounces of just beef every day. That’s too much.”
Of course, no one likes to be told what not to eat. That’s why the National Cancer Institute and other health advocates have decided to accentuate the positive plant foods. They now urge Americans to “strive for five”—eat at least five servings of fruits and vegetables each day. Unfortunately, many studies show that less than one-third of Americans get their five.
I’m no nutritional saint, but I always eat my five a day. I do it by being a near-vegetarian. I eat freshwater fish or seafood once or twice a week, a chicken breast once every few months, and whatever my mother-in-law serves. But my diet is plant-based—and liberally seasoned with culinary herbs, including garlic and rosemary, which contain antioxidant nutrients that help prevent heart disease, cancer, and stroke.
Herbal relief for a male problem
My friend Jim Duke is betting his prostate on saw palmetto, and he’s persuaded me to do the same. For most of his thirty-year career with the U.S. Department of Agriculture, Jim, who has a Ph.D. in botany, was the federal government’s chief herbalist. He’s also written several herb books, most recently The Green Pharmacy (Rodale, 1997).
Jim is now sixty-eight. In his fifties, his prostate began doing what middle-aged prostates do—growing, a condition called benign prostatic hyperplasia, or BPH (“benign” means it’s noncancerous, and “hyperplasia” means abnormal growth rate of normal cells). The prostate is located under the bladder, and the urine tube (urethra) runs through it. As BPH develops, prostate overgrowth pinches the urethra, and men develop a variety of urinary symptoms: urgency (needing to go immediately), hesitancy (trouble getting started), dribbling (trouble finishing), and the most annoying one, nocturia—having to get up at night to urinate.
An estimated 60 percent of men between the ages of forty and fifty-nine experience BPH symptoms, and it’s estimated that four of every five men will develop BPH by age eighty. Most men can live with getting up once a night. But when it becomes necessary two or three times a night, even doctor-phobic men look for medical relief.
For years, the only treatment available was surgery—a procedure known as transurethral resection of the prostate (TURP). The surgeon threads a flexible tube up the urethra to access the area, then snips away enough overgrown prostate tissue to relieve urethral pinching. This procedure can provide long-term relief of BPH symptoms, but the operation carries a small risk of incontinence and erection impairment. In addition, many men lose the ability to ejaculate. Orgasm remains pleasurable, but semen is ejaculated into the bladder, then leaves the body during urination.
Recently, two prescription drugs have been introduced that prevent or at least delay the need for surgery. Finasteride (Proscar) reverses overgrowth of prostate tissue, and terazosin (Hytrin) relaxes the muscles around the urethra so it widens. Proscar generally works best for men older than sixty and Hytrin for men in their fifties. But these drugs can cause side effects such as dizziness, lightheadedness, and a small risk of impotence.
Enter Jim Duke’s solution. During the early 1980s, researchers discovered that an extract of the berries of the saw palmetto tree (Serenoa repens) helps shrink overgrown prostate tissue, an action similar to Proscar. Studies have shown it is effective, one of the largest a 1993 report involving 505 men who took saw palmetto for moderate BPH symptoms. Most showed improvement of urinary symptoms after forty-five days, and 88 percent reported significant improvement within ninety days. The typical recommendation is a twice daily dose of 160 mg of a standardized saw palmetto extract, which is available in health-food stores and pharmacies. You don’t need a prescription to buy it.
Thanks to saw palmetto, Jim Duke’s prostate symptoms are under control. He hasn’t had to resort to either surgery or pharmaceuticals, and he says he likes it because not only is it an herbal medicine, but also it’s less expensive than drugs and it causes fewer side effects.
A remedy for battle wounds
For years, naturopaths have prescribed pineapple and bromelain supplements for musculoskeletal injuries—sprains, bursitis, tendinitis, muscle strains, and more. These injuries often befall men either because of their work (farming, construction trades, factory labor) or their play (sports). Pineapple contains an enzyme called bromelain, which has anti-inflammatory properties. In a 1995 German study, thirty-nine men and twenty women with musculoskeletal injuries were given 500 mg of bromelain three times daily a half-hour before meals for one to three weeks. Compared with expected healing time without treatment, the bromelain regimen significantly speeded healing.
The pharmaceutical approach would be nonsteroidal anti-inflammatory drugs (NSAIDs), which are more expensive and may cause bleeding in the digestive tract. The only side effects reported from bromelain were a few cases of gas and nausea. Bromelain is available at most health-food stores.
I have my share of old sports injuries—bad knee, bad shoulder. I haven’t taken supplemental bromelain, but when any of my aches or pains act up, I eat more pineapple. It may be a placebo response, but I think it works—and without the stomach upset aspirin may cause.
What did you say?
Men’s hearing often begins to deteriorate during their twenties, while women generally don’t experience this condition until after age sixty, according to researchers at the National Institute on Aging. Their results were based on hearing tests of 1,000 men and women every two years for twenty-three years. None of the men in the study worked in particularly noisy jobs such as construction. What impaired their hearing so early in life? Prolonged exposure to noisy devices at home: power tools, power lawn mowers, and loud music. Keep the music low, guys, and, when working with noisy machinery, wear earplugs. Inexpensive foam earplugs are available at drugstores.
Plant foods also can help. George Gates, M.D., an ear, nose, and throat specialist at the University of Washington in Seattle, has discovered that arterial clogging, which causes heart attacks and most strokes, contributes to hearing loss. His prescription: A low-fat, high-fiber diet based on plant foods.
Additionally, ginkgo (Ginkgo biloba) has been shown to improve persistent hearing problems. In one French study, 4 ml (about 1 teaspoon) of a standardized ginkgo extract taken twice daily significantly improved hearing loss caused by clogged blood vessels in the ear. Another French study showed that ginkgo also helps treat chronic ringing in the ears (tinnitus). In that study, 103 chronic tinnitus sufferers who took 2 ml of a standardized ginkgo extract twice daily experienced significant improvement in thirteen months.
Sex can be great
Ginseng, chocolate, coffee, alcohol, powdered rhinoceros tusk, a ground up Mediterranean beetle, and the bark of a certain West African tree don’t appear to have much in common, but they are only some of the many “treatments” men have used through the ages to enhance sex. For nearly as long, scientists have dismissed such aphrodisiacs as sexually worthless and sometimes dangerous.
But old beliefs die hard when they promise to add extra zest to lovemaking. The rhinoceros has been hunted almost to extinction, in part because its powdered horn reputedly boosts virility (it doesn’t). And Spanish fly, a drug made by pulverizing the Mediterranean beetle, is a urinary tract irritant that can be poisonous in large doses.
But recent research shows that, although traditional aphrodisiacs don’t unleash unbridled lust, several stimulate more than just the imagination:
• Caffeine (in coffee, tea, cocoa, chocolate, and colas) may do more than simply keep the sandman at bay. In one study, University of Michigan urologist Ananias Diokno, M.D., found that regular coffee drinkers were considerably more sexually active compared with those who do not drink coffee.
• Chocolate contains not only caffeine but also what sexual medicine specialist Theresa Crenshaw, M.D., co-author with James Goldberg, Ph.D. of Sexual Pharmcology (Norton, 1996), calls “the molecule of love”, phenylethylamine (PEA). PEA is a natural form of the stimulant amphetamine and an antidepressant. Both love and lust increase blood levels of PEA, but after a heartbreak PEA levels plummet. Chocolate contains high levels of PEA, which may account for its centuries-old reputation as an aphrodisiac.
• Ginseng doesn’t contain caffeine, but it does contain stimulants known as ginsenosides that appear to enhance work performance. American scientists remain skeptical, but several Asian animal studies suggest that Panax ginseng also stimulates sexual function. Ginseng preparations are available at health-food stores. The usual dose is 1/2 teaspoon of powdered root per cup of boiled water, up to two cups a day. Unlike coffee, ginseng does not produce a quick buzz. It must be used regularly for several months before its subtle stimulant effect becomes noticeable.
• Yohimbe, from the bark of the West African yohimbe tree (Pausinystalia yohimba), has long been reputed to restore erections in impotent men. Scientists scoffed, but several studies during the 1980s showed that a chemical in the bark, yohimbine, did help some impotent men by stimulating blood flow into the penis. Some years ago, the U.S. Food and Drug Administration approved yohimbine as a treatment for impotence. The pure compound is now available in prescription form: including Erex, Yocon, and Yohimex.
However, since its FDA approval, some medical naysayers have continued to assail yohimbine as ineffective. A recent review of sixteen studies showed that yohimbine was effective for erection impairment. But because the herb carries a risk of serious side effects, including anxiety, increased heart rate, and elevated blood pressure, Jim Duke cautions against using the herb because the prescription drug form offers a safer approach.
San Francisco medical journalist Michael Castleman has written eight books including The Healing Herbs (Rodale, 1991, Bantam, 1994) and Nature’s Cures (Rodale 1996, Bantam, 1997).
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