• Archives
  • Jan21

    Osteoporosis is thought of as a women’s disease, but osteoporosis in men can be even more dangerous.

    Men are at greater risk of complication and death when they fracture their hip than are women: men are twice as likely to die as women after a fracture.

    Up to 25% of men over the age of 50 will break a bone due to osteoporosis or because of low bone mass, and about 80,000 men break their hips each year. Bone is constantly changing and old bone is replaced by new bone.  But that’s not the way you want to remodel your bones.

    Osteoporosis, courtesy of Health News Updates

    As we age though, the rate of change of bone remodeling declines.

    Men in their 50s experience less bone loss than women of the same age. Somewhere between the ages of 65 and 70, the playing field is leveled and men lose just as much of their bone density as women, which makes them more prone to debilitating fractures.

    This is where healthy weight loss and muscle gain come into play.

    Being obese or overweight will put extra stress on your bones, but losing weight rapidly puts you in a position of greater risk for osteoporosis.

    When you drop weight rapidly, you lose important minerals and hormones such as testosterone.  A low testosterone level is one culprit behind osteoporosis in men. Too much alcohol, long term steroid use, smoking, and a low vitamin D level are four others.

    One way men can increase testosterone levels is by working out. Lifting weights twice a week will help your upper body, and a brisk walk for 30 minutes daily will begin to fortify your hip bones. Not only will exercising build your muscle mass and strength, but it will also help to increase your bone density, which will put you one step closer to preventing osteoporosis.

    Changing your diet will also help you lose weight and prevent osteoporosis. I suggest at least 600 IU of Vitamin D3, and up to 1000 (measure your level!)  and no supplement of calcium: you don’t need it if you get enough greens and dairy.

    Start with a gradual change in exercise and diet to give you a head start on preventing osteoporosis. See your doctor if you have any questions or want a bone density evaluation: if you have osteoporosis, and you’re over 40 and you’re a man, you need a testosterone level check.

     
  • Jan14

    Problems with weight control can be an issue for your health, but did you know overweight could also be causing depression?

    When a man gains those extra pounds around his waist, which is where men do, his testosterone levels may be reduced.

    DepressionTestosterone affects a man’s mood and outlook on life. It also helps build stamina, and increases sex drive, energy, and motivation. Testosterone levels in men commonly fall naturally over time through aging, though they don’t have to: testosterone decline is not necesarily part of normal aging.  Being overweight in the middle, with visceral fat, can also significantly decrease those levels. That can lead to depressed mood, irritability, a loss of vitality, and poor sex drive. And performance, not just in bed, but at work.

    A man as little as 30 pounds overweight can be affected. Studies have shown that if a man who is 6’1” gains 30 pounds he will suffer a drop in testosterone equivalent to adding 10 years to his current age.

    A male who displays any of the following behavior may be showing symptoms of undiagnosed depression.

    • Anger issues
    • Regular substance abuse
    • Constant controlling or violent behavior
    • Being overly involved in work or sports
    • Infidelity
    • Hazardous behavior or unnecessary risks

     
    I’d like to use this space on my Paging Dr. La Puma blog to let you know that depression can be treated. Drugs do help some people who are seriously ill, but for most people, there are reasons to consider food, fitness, sleep and mindset measures first.

    Try adding these foods to your diet to help give your mood a boost; walnuts, fish, dark chocolate, saffron, lentils, and chilies. An easy meal to help combat depression and is also easy on the waistline would be my Saffron Scallop, Shrimp, and Chickpea Paella recipe.

    Depression in males often goes undiagnosed. Anyone with symptoms is urged to seek out help, especially if you’re considering hurting yourself. If you’re depressed, need help and your doctor is unavailable, call the USA Depression Hotline- 630-482-9696

     

    Araujo, A. B., Travison, T. G., Bhasin, S., Esche, G., Williams, R., Clark, R., &     McKinlay, J., (2008, November). Association of Testosterone and Estradiol with Age-Related Declines in Physical Function in a Diverse Sample of Men. J Am Geriatr Soc.56(11), 2000-2008.

     
  • Sep20

    JAMA’s new theme issue on obesity (linked table of contents below) has a point counter point in a network TV new report on the male boomer interest in testosterone.

    Visceral fat in men converts testosterone into estrogen. That causes or exacerbates dulled sex drive, poor energy, irritability, insomnia, erectile dysfunction, loss of muscle mass and more.  All from belly fat.

    In this new ABC clip, a 57 year old uses T for an edge in work, and proudly shows off his biceps.  He’s lost 30# and feels great (stopping the estrogen conversion helps).

    But could have he done this without the injections? It doesn’t appear that his level was clinically low.

    Unacknowledged: manly eating.  There are natural ways to boost testosterone, lose the gut, improve sex drive and build muscle. Diane Sawyer looks concerned.  Are you?

    Read the JAMA pieces below for current mainstream medical thought on the epidemic…minus testosterone.

    Viewpoint

    The Role of Government in Preventing Excess Calorie Consumption:  The Example of New York City
    Thomas A. Farley, MD, MPH
    JAMA. 2012;308(11):1093 doi:10.1001/2012.jama.11623

    The Next Generation of Obesity Research:  No Time to Waste
    Griffin P. Rodgers, MD; Francis S. Collins, MD, PhD
    JAMA. 2012;308(11):1095 doi:10.1001/2012.jama.11853

    FDA Approval of Obesity Drugs:  A Difference in Risk-Benefit Perceptions
    Elaine H. Morrato, DrPH, MPH; David B. Allison, PhD
    JAMA. 2012;308(11):1097 doi:10.1001/jama.2012.10007

    Cardiovascular Risk Assessment in the Development of New Drugs for Obesity
    William R. Hiatt, MD; Allison B. Goldfine, MD; Sanjay Kaul, MD
    JAMA. 2012;308(11):1099 doi:10.1001/jama.2012.9931

    Original Contribution

    Exercise Dose and Diabetes Risk in Overweight and Obese Children:  A Randomized Controlled Trial
    Catherine L. Davis, PhD; Norman K. Pollock, PhD; Jennifer L. Waller, PhD; Jerry D. Allison, PhD; B. Adam Dennis, MD; Reda Bassali, MD; Agustín Meléndez, PhD; Colleen A. Boyle, PhD; Barbara A. Gower, PhD
    JAMA. 2012;308(11):1103 doi:10.1001/2012.jama.10762

    Association Between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents
    Leonardo Trasande, MD, MPP; Teresa M. Attina, MD, PhD, MPH; Jan Blustein, MD, PhD
    JAMA. 2012;308(11):1113 doi:10.1001/2012.jama.11461

    Health Benefits of Gastric Bypass Surgery After 6 Years
    Ted D. Adams, PhD, MPH; Lance E. Davidson, PhD; Sheldon E. Litwin, MD; Ronette L. Kolotkin, PhD; Michael J. LaMonte, PhD; Robert C. Pendleton, MD; Michael B. Strong, MD; Russell Vinik, MD; Nathan A. Wanner, MD; Paul N. Hopkins, MD, MSPH; Richard E. Gress, MA; James M. Walker, MD; Tom V. Cloward, MD; R. Tom Nuttall, RRT; Ahmad Hammoud, MD; Jessica L. J. Greenwood, MD, MSPH; Ross D. Crosby, PhD; Rodrick McKinlay, MD; Steven C. Simper, MD; Sherman C. Smith, MD; Steven C. Hunt, PhD
    JAMA. 2012;308(11):1122 doi:10.1001/2012.jama.11164

    Health Care Use During 20 Years Following Bariatric Surgery
    Martin Neovius, PhD; Kristina Narbro, PhD; Catherine Keating, MPH; Markku Peltonen, PhD; Kajsa Sjöholm, PhD; Göran Ågren, MD; Lars Sjöström, MD, PhD; Lena Carlsson, MD, PhD
    JAMA. 2012;308(11):1132 doi:10.1001/2012.jama.11792

    Surgical vs Conventional Therapy for Weight Loss Treatment of Obstructive Sleep Apnea:  A Randomized Controlled Trial
    John B. Dixon, MBBS, PhD, FRACGP; Linda M. Schachter, MBBS, PhD; Paul E. O’Brien, MD, FRACS; Kay Jones, MT&D, PhD; Mariee Grima, BSc, MDiet; Gavin Lambert, PhD; Wendy Brown, MBBS, PhD, FRACS; Michael Bailey, PhD, MSc; Matthew T. Naughton, MD, FRACP
    JAMA. 2012;308(11):1142 doi:10.1001/2012.jama.11580

    Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults
    Ian J. Neeland, MD; Aslan T. Turer, MD, MHS; Colby R. Ayers, MS; Tiffany M. Powell-Wiley, MD, MPH; Gloria L. Vega, PhD; Ramin Farzaneh-Far, MD, MAS; Scott M. Grundy, MD, PhD; Amit Khera, MD, MS; Darren K. McGuire, MD, MHSc; James A. de Lemos, MD
    JAMA. 2012;308(11):1150 doi:10.1001/2012.jama.11132

    Editorial

    Progress in Filling the Gaps in Bariatric Surgery
    Anita P. Courcoulas, MD, MPH
    JAMA. 2012;308(11):1160 doi:10.1001/jama.2012.12337

    Progress in Obesity Research:  Reasons for Optimism
    Edward H. Livingston, MD; Jody W. Zylke, MD
    JAMA. 2012;308(11):1162 doi:10.1001/2012.jama.12203

     
  • Dec8

    Our ABC station (KEYT, and former CNN editor Shirin Rafaee) asked me about Dr Oz’ 4 Secret Reasons Women Are Exhausted (previously, we spoke about belly fat). Here they are:

    1. Carb Coma: a catchy way to sum up the sharp drop in blood sugar and shunting of blood to your stomach (not to your brain!) when you have a breakfast of pastry, or just high sugar fruit.  To gain energy, Oz reminds us to eat oatmeal and one fruitStress Free Quiz, not two, and to eat a hardboiled egg before leaving the house, and add vegetables to keep feeling full.

    This is good advice, generally. Too many of us just have cereal or nothing for breakfast, and skip the protein. I’d add nuts and avocado, and make the oats steel-cut. I like my patients to aim for 30% of their daily calories at breakfast, and 60% by 2 pm.

    2. Hormone Hell: Oz tests for high levels of cortisol and low levels of testosterone, which is suppressed by too high cortisol. Cortisol keeps spiking during the day in stressed and exhausted people, instead of its normal pattern; women need (and make) testosterone too.

    In men, I think that testosterone actually is the weight loss hormone (even more than leptin), and knowing that, women can make a huge difference for men who need to lose weight.

    In women, it depends on age:  women over 65 who have insulin resistance and metabolic syndrome often have high (not low) testosterone levels. In other women, testosterone gradually declines. One (unaccepted) theory is that their adrenal glands can’t keep up with chronic fight-or-flight arousal of chronic stress, and don’t produce enough of the hormones needed, including testosterone.

    To help, Oz suggests getting 8 hours of sleep and 18 minutes of exercise daily, a balanced diet, and taking supplements, including Tongkat Ali (a Malaysian herb, now a protected species from overharvesting, made into a tea which improves sexual performance in male rats and mice), also available as a powder and an extract.  Claims about Tongkat Ali are sensational: I could find no studies of effectiveness in women, and only one in men (for infertility).

    3. OTC Pain Meds can cause sleepiness.  Yes, they can–between 3 and 9% of people taking naproxen, for example, report just that. Oz suggests taking them just once weekly, and trying peppermint oil compresses instead.  I think less reliance on medication is a good thing. Sharecare and HealthTap are leading the way online in providing better DIY and DIT advice f.

    4. Don’t sleep with your pets.  I think this is good advice: Oz notes that if a pet is restless at bedtime, they might need more exercise during the day, and might be keeping you up at night. Oz suggests giving a pet her own bed, and making the transition if you’ve slept (or tossed and turned) that way for years.

     
  • Nov23

    From Babble.com: http://www.babble.com/CS/blogs/strollerderby/archive/tags/BPA/default.aspxSoup is good food. It’s especially good for weight loss. Bob Barnett and Barbara Rolls based the best-selling Volumetrics around the idea that dishes low in calories (i.e., lots of water) and slow-to-eat (i.e., soup!) were the best for losing weight. There’s something to that.

    It’s a cruel paradox, then, that a new JAMA report on BPA shows a level 12x higher (a 1200 percent increase) in eaters 12 hours after they ate 12 ounces of any of 5 Progresso canned vegetable soups, than when they ate homemade vegetable soup.

    It is little known that the obesity epidemic coincides with a similarly linear increase in industrial chemicals–endocrine disruptors that act as estrogens in the body–over the past decades.  Coincidence? I doubt it.

    BPA may be stored in fat.  It interacts with a thyroid hormone receptor, potentially slowing metabolism.  BPA acts as a weak estrogen in the body, causing men to lose some ability to build muscle and metabolize sugar. In the lab and in animals, BPA acts as an androgen receptor antagonist. Men need testosterone to build muscle and keep weight off. In all adults, BPA is associated with heart disease and diabetes.

    Why do we have BPA? It protects plastics and prevents the inside of cans from rusting. But it may also prevent you from losing weight.

    Are there canned alternatives? Yes: you can buy BPA-free Eden beans, Crown Prince salmon and Muir Glen tomatoes; you can buy BPA-free Earth’s Best baby food and travel mugs; you can buy BPA-free espresso makers and jet soda makers.

    But there is no alternative to knowing what’s in your food, and to beginning to look at how what’s in your food changes your weight.