Attitudes towards men’s health in Australia have undergone a complete transition in the past 40 years, writes naturopath Tania Flack.

The days of “She’ll be right mate,” have given way to more mindful, proactive approaches, partly due to the excellent work of public health campaigns like Movember, which raises awareness about common men’s health issues like prostate cancer, testicular cancer, and men’s mental health.

Unfortunately, even though men’s attitude towards their health may have changed it has not automatically translated to a rebalancing in the discrepancy between Australian men and women’s health and life expectancy. The latest statistics from the Australian Bureau of Statistics show that a male born in Australia in 2006–2008 could be expected to live 4.5 years less than a female born at the same time (79.2 years compared with 83.7). Men are also far more likely to develop cancer by the age of 75 (44%) compared to women (30%). They also have a 1.6 times higher risk of having a chronic condition caused by injury compared to women; and while the nation's rate of cardiovascular disease continues to rise, it is more common amongst men (5.7%) than women (4.7%).”

Perhaps the best way to continue to close the gap between men and women’s health in Australia is to focus on preventive health care. Health education should start in childhood and focus on healthy nutrition, developing cooking skills, regular exercise, and open discussions about health. Modifying diet and lifestyle risk factors is the most proactive way that men can stay on top of their health. So what are the most common health concerns for men and how can improving diet and lifestyle help?

Weight problems

Being overweight is perhaps the most common men's health problem, with the most recent figures from the Australian Bureau of Statistics showing that a staggering 71% of men aged 18 years and over are overweight or obese, an increase from 64% in 1995. Achieving and maintaining a healthy weight is the single most effective thing men can do to reduce their risk of developing a wide range of chronic health problems. Being overweight not only increases the risk of diabetes, cancer, and heart disease; there is also good evidence to suggest that it contributes to dementia risk as men age. While this may not be a high priority for younger men, sexual performance is: being overweight also significantly increases risk of type II diabetes, which is a major cause of erectile dysfunction.

Sadly we have normalised being overweight. Phases like ‘beer gut’ and having 'a dad body’ make fun of expanding waistlines, where they should be a cause for concern. Taking a simple waist measurement can help identify problems. Ideally, men should have a waist measurement less than 94cm, anything more indicates an increased deposition of intra-peritoneal fat (fat deposited around the organs) which is inflammatory and perhaps the greatest single predictor of chronic health problems. Happily, this entirely preventable and losing even 10 kilos when overweight can significantly reduce your risk of developing a chronic health condition. Taking a proactive approach to weight management and getting professional support makes a huge difference. Getting your doctor on board along with a qualified nutritionist and personal trainer can ensure you set realistic goals, stay on track and achieve long-term results. Being clear about why you need to reach a health weight helps to simplify setting goals for your future health.

Low energy

Feeling tired is a common complaint, and it's no wonder when you consider the pressures of the modern world; long hours spent at work, commuting to and fro, and family or social commitments can leave men with little personal time. Add to that the perils of office work and sitting most of the day and you have a recipe for fatigue and chronic health conditions. According to Safe Work Australia, prolonged sitting is associated with cardiovascular disease, diabetes, obesity, poor mental health, some cancers and premature death. One of the fastest ways to improve energy and indeed reduce your risk of major chronic health problems is to exercise regularly, but that message is not getting through. The Australian Bureau of Statistics reports that only around half (49%) of men aged 18-64 years participated in enough physical activity (150 minutes per week over five sessions) to keep healthy.

Good nutrition provides the basic building blocks for healthy energy levels, however the average Australian man is just not getting enough of what he needs. Borderline deficiencies in key nutrients, such as magnesium, zinc and B group vitamins, are not uncommon and contribute to poor energy levels. The more stress you are under, the greater the requirements for these important nutrients. Statistics show us that men are just not eating enough of the types of foods that contain these nutrients, namely vegetables and fruit. In 2014-2015 only 3.8% of men ate the recommended five to six serves of vegetables per day and only 44% of men ate the recommended two serves of fruit. If you feel tired all the time, then you need make changes. Fatigue is a genuine warning sign that your diet and lifestyle is not supporting your workload. Addressing nutrition, eating a varied whole foods diet, and exercising regularly can make a profound difference.

Poor sleep

One cornerstone of good health is quality, regular, deep sleep to help the body rest and repair. However, sleep can elude some people and studies show that between 13 and 33 percent of Australian adults have difficulties either getting to sleep or staying asleep. This can be due to a number of factors including mental health problems such as depression and anxiety, which can contribute to chronic sleep disorders. Another condition that leads to poor quality sleep is obstructive sleep apnoea, a condition where the soft palate either partially or completely collapses during sleep, obstructing the airway and leading to poor oxygen delivery which disrupts sleep quality, leaving people feeling exhausted the next day. A recent study shows that while one in 10 Australians suffer from undiagnosed obstructive sleep apnea, men are particularly at risk; it is estimated to affect approximately 49% of men between the age of 40 to 69 and could be as high as 62% in men over the age of 70. Obstructive sleep apnoea is often associated with weight problems and losing weight is often the first step in managing the condition. A good night's sleep requires a comfortable temperature, proper ventilation, and a lack of light and noise as a minimum. Other steps to improve sleep are avoiding alcohol and caffeine, developing a relaxing night-time routine and avoiding using the computer and other blue screen devices late at night.

Mental health

Perhaps the most profound shift in Australian men’s health to date has been the improvement in awareness of mental health. This is partly thanks to the bravery of high-profile Australians such as Ian Thorpe and Buddy Franklin who have openly shared their stories and experiences of mental health challenges, and partly due to the
fantastic work of organisations such as Movember, Beyond Blue, The Black Dog Institute, Headspace, Australian Men’s Shed Association, and RU OK day. Up until recent years, Australian men were more likely to bottle up emotions and not seek help for mental health problems. This is improving, but there is still a long way to go and The Black Dog Institute estimates that even today up to 72% of men do not seek help for mental health problems. Despite the fact that women are slightly more likely to suffer depression than men, men are more likely to commit suicide and the number of men who die from suicide in Australia every year is nearly double the national road toll.
Good mental health relies on a number of factors, including supportive close personal relationships with family and friends, good physical health, regular exercise, and adequate sleep. Nutrition is also vital for good mental health and recently a study undertaken by researchers at Deakin University found that a Mediterranean-style diet, rich in vegetables, legumes, whole grains, fresh fruit, olive oil, nuts and seeds, had profound benefits for people with depression. So if you feel like your mental health could be improved, seek help: talk to the people you are closest to, consult a health professional, draw from all the great resources available online, and really focus on your physical health, especially diet and exercise. A proactive approach to mental health problems can make all the difference.

Declining fertility

Alarming new research shows Western men’s fertility has declined by more than 50% in the last 40 years and the steep decline shows no signs of slowing. This large meta-analysis drew data from more than 185 studies, which included information from 43,000 men in North America, Europe, Australia and New Zealand. Researchers have associated this decline with environmental and lifestyle factors such as prenatal chemical exposure, adult pesticide exposure, smoking, stress, and obesity. The study also found that a low sperm count predicts morbidity and mortality, acting as a sensitive measure of how men are being affected by environmental toxicity and lifestyle factors. These findings have wider implications for public health than fertility alone and highlight the need, not only for preconceptual care, but for men to focus on ongoing preventive health care.
Protecting men’s fertility should begin early in life and reducing exposure to chemicals and pesticides is a good place to start. Thoroughly washing fruit and vegetables or eating organic significantly reduces exposure to toxins. Ensuring a nutrient-rich diet will also help. Men need preconceptual care as much as women and I advise all men planning a family to see their local naturopath or nutritionist at least three months prior to starting a family to get advice on how to reduce toxicity, promote fertility, and get in great shape for fatherhood.

Prostate health

The prostate is exquisitely sensitive to environmental toxicity and lifestyle factors, such as smoking, being overweight, and a poor diet. This has contributed to an exponential rise in prostate problems. Many common chemicals, pesticides and plastics are known to have endocrine-disrupting properties. These have the potential to cause proliferation of hormonally sensitive tissue and may be harmful to the prostate gland. Avoiding unnecessary exposure to these types of chemicals is an important step in protecting prostate health and fertility in men.
Prostate health is not often a concern for younger men, however perhaps it should be as approximately one in seven men over the age of 40 experience problems with their prostate. The most common problem is benign prostatic hyperplasia (BPH) which causes enlargement of the prostate gland, which over time puts pressure on the bladder, which leads to difficulty urinating. Prostate cancer is the most common cancer diagnosis in Australia and it is estimated that 16,665 new cases will be diagnosed this year alone. It causes more deaths than breast cancer, yet gets only a fraction of the media attention. This really highlights one of the fundamental differences between men and women’s health in Australia: despite improvements in attitudes to men’s health we are still not talking about it enough.

Prevent prostate cancer
1. Eat fewer calories or exercise more, so that you maintain a healthy weight.
2. Try to keep the amount of fat you get from red meat and dairy products to a minimum.
3. Watch your calcium intake. Do not take supplemental doses far above the recommended daily allowance. Some calcium is OK, but avoid taking more than 1,500 mg of calcium a day.
4. Eat more fish – evidence from several studies suggests that fish can help protect against prostate cancer because they have “good fat”, particularly omega-3 fatty acids. Avoid trans fatty acids (found in margarine).
5. Try to incorporate tomatoes that are cooked with olive oil, which has also been shown to be beneficial, and cruciferous vegetables (like broccoli and cauliflower) into many of your weekly meals. Soy and green tea are also helpful.
6. Avoid smoking for many reasons. Drink alcohol in moderation, if at all.
7. Seek medical treatment for stress, high blood pressure, diabetes, high cholesterol, and depression. Treating these conditions may save your life and will improve your survivorship with prostate cancer.
9. Relax and enjoy life. Reducing stress in the workplace and home will improve your survivorship and lead to a longer, happier life.