Men's Health

Men face unique health challenges, from higher rates of heart disease and prostate conditions to poorer mental health outcomes. This article explores the key risk factors, dietary considerations, and evidence-based supplements — including omega 3, magnesium and zinc — that can support men's long-term health and wellbeing.

Men's Health

Men's health is an area which is starting to become more of a concern as figures show that men have a lower life expectancy1 and are also more than 3 times more likely to die by suicide2 than women. Men are less likely to seek medical help or consult their GP than women3 and are more likely to engage in behaviours which are detrimental to health such as smoking4 and drinking alcohol to excess.5

Introduction

There have been several male-specific health initiatives in the last 20 years, which have aimed to improve areas such as weight loss, exercise and activity and mental health. However, despite this improvement in reaching out to men, figures from a working group which includes The Men's Health Forum and the Mankind Initiative,6 show that one in five men die before the age of 65. The causes are often preventable or treatable and include cancer, heart disease, diabetes and alcohol related issues. COVID has also had a significant effect with two-thirds of those hospitalised being male,7 and men being 60% more likely to die from the virus.8 Men are also 32% less likely to seek help from their GP9 and they access services like talking therapies10 and NHS Health Checks,11 which can identify early signs of heart disease and diabetes, less often than women. Studies suggest that men have a lower health literacy than women;12 finding it harder to access, comprehend and use information and services to aid health related decisions. Early studies in the 1990s and 2000s suggested that this may be due to an ongoing adherence to traditional “masculine” values of stoicism and self-reliance, and public health initiatives are starting to try and breakdown the barriers to men's health.13

Data also suggests that men tend to have much less healthy lifestyles than their female counterparts, with women on average living for 5 years longer than men. Men are more likely than women to be overweight or obese (68.6% versus 59%),14 more likely to smoke (14.6% versus 11.2%)15 and more likely to drink alcohol on a daily basis (8% versus 5%).16 Men also tend towards eating less fruit and vegetables and more than 50% more red and processed meat than women (89g/d versus 56g/d).17

Heart Disease

There are a number of conditions which will affect a proportionally higher level of men, or even men only. One of the most significant of these is cardiovascular disease (CVD). This condition affects 1 in 8 men and 1 in 14 women in the UK and develops at a younger age in men.18 Men also have a higher risk of coronary heart disease (CHD),19 which has been partially attributed to the protective effects of oestrogen on women's hearts; this hormone is known to contribute to regulation of lipids, coagulation, inflammatory markers and vasodilation. Some experts also consider differences in stress levels or the way it is dealt with, less adherence to a healthy diet and less overall understanding of their health and well-being may also be linked to a higher risk in men.

Male Specific Health Concerns

Other conditions significantly affecting men are prostate and erectile problems. Benign prostatic hyperplasia (BPH) affects 50% of men aged 50–60, increasing to 90% in men aged 80+, according to the Urology Foundation. Erectile dysfunction (ED) affects over 4 million men in the UK and is particularly significant as it can be an early marker for the development of other conditions.20 One study has positively correlated ED with CVD and shown that those with ED are more likely to develop dementia.

Mental Health

Men's mental health is also a significant concern in the UK: statistics show that three-quarters of suicides are male, and men are three times more likely to become dependent on alcohol than women, according to Public Health England. These issues can also be causative for other conditions; depression, anxiety and stress can lead to physiological changes such as increases in blood pressure and cortisol and a decrease in blood flow.13 These make the development of heart and metabolic diseases more likely. Studies also suggest that those with these mental health conditions are less likely to have healthy coping mechanisms and are therefore more likely to avoid medication or lead an inactive or unhealthy lifestyle.

Diet

A Mediterranean style diet is probably one of the most relevant ones for men to consider. This diet focuses on polyphenol, potassium and magnesium rich fruits and vegetables, foods such as nuts and seeds which contain both omega 3 and 6 fatty acids, olive oil and lean meats and oily fish, such as herring, mackerel, salmon and sardines which are also rich in omega 3 fats. Processed foods are avoided, and the emphasis is on the consumption of fresh, unprocessed or minimally processed foods which are naturally much lower in sugar, salt and trans and hydrogenated fats. This diet is associated with an improvement in CVD risk, with reduced instances of CHD and stroke. Adherence to this diet is also associated with a decreased risk of depression, cognitive decline, obesity (especially abdominal obesity),21 type 2 diabetes22 and improvements in overall mortality.23

National Diet and Nutrition Surveys indicate that there are some nutrients which are likely to be lacking in the diets of some men. Some of the lowest intakes can be seen for Vitamin A (55% of men consume levels below the recommended intake), magnesium (50%) and zinc (45%). Zinc is well known for its effects on testosterone production,24 fertility (via spermatogenesis) and reproductive health.25 Magnesium is recognised for psychological function via its effects on the functioning of the central nervous system and can also contribute to a reduction in heart health risk factors such as blood pressure, metabolic syndrome and dyslipidaemia. Vitamin A is recognised as an antioxidant nutrient and therefore is linked to decreases in oxidative stress, with several studies showing that a higher dietary intake is associated with lower levels of heart disease.26

Supplements

With these intakes in mind, a good multivitamin and mineral should probably be the first option for male health support. This should also include B vitamins as an adequate intake of B vitamins, especially B6, B12 and folic acid will all be useful for supporting normal homocysteine, an excess of which is associated with heart disease, cognitive impairment, and depression. In cases where MTHFR mutations may be present then methylated forms of those B vitamins, pyridoxyl-5-phosphate (P5P), methylcobalamin and methylfolate can be considered.

Additional magnesium supplementation is also strongly advisable due to its association with heart health, as it can contribute to normal muscle function. Studies have found magnesium supplementation to be effective in lowering high blood pressure in those suffering with hypertension.27 This may be via several different mechanisms including the reduction of vascular stiffness, reduction of vascular resistance and lowering of circulating volume. Low magnesium status is also associated with erectile dysfunction,28 as magnesium is involved in the metabolism of nitric oxide, which then controls penile blood flow.

Omega 3 fatty acids, especially the EPA and DHA found in oily fish, should also be considered to support heart health. NDNS data shows that the intake of oily fish is low in the UK and omega 3 intakes are particularly poor when compared to other fats. A combined intake of 250mg of EPA and DHA can contribute to normal heart function and an intake of 3g of these two fatty acids a day can contribute to the maintenance of normal blood pressure. Numerous studies have found a strong link between the use of fish oil and improvements in CHD mortality, and these effects may be due to several mechanisms including the reduction of inflammation and the stabilisation of cell membranes.29 Evidence suggests that a sufficient intake can normalise triglycerides, reduce blood pressure, reduce inflammation and reduce the formation of plaques in the arteries.

Omega 3 has also been shown to improve volume of grey matter in the brain as well as overall working memory performance. DHA is the main fat found in brain tissue30 and has many different roles to play in improving mood disorders and supporting cognitive function.31 Lower intakes of DHA are associated with higher levels of depression and DHA intakes are also associated with lower anxiety scores.32 Omega 3 fatty acids are also associated with improvements in BPH.33

Saw palmetto is also commonly recommended for benign prostatic hyperplasia (BPH) or prostate enlargement. This plant provides compounds known as beta sitosterol which have been shown to reduce the conversion of testosterone to another androgen known as dihydrotestosterone (DHT). As high DHT in adulthood is associated with an enlargement of the prostate, saw palmetto and beta sitosterols have been widely researched to help relieve symptoms of BPH, including urinary urgency, difficulty in urination, dribbling, slow urination and nocturia.34

References

  1. Office for National Statistics. National Life Tables, United Kingdom: 2022 to 2024. ons.gov.uk
  2. Office for National Statistics. Suicides in the United Kingdom: 2023. ons.gov.uk
  3. Wang Y, Hunt K, Nazareth I, Freemantle N, Petersen I. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open. 2013;3(8):e003320.
  4. NHS Digital. Statistics on Smoking: England 2019. digital.nhs.uk
  5. NHS Digital. Health Survey for England 2015: Adult Alcohol. digital.nhs.uk
  6. Men's Health Forum. Levelling Up Men's Health: The Case for a Men's Health Strategy 2022. menshealthforum.org.uk
  7. Office for National Statistics. Deaths involving COVID-19 by month of registration, UK. September 2021. ons.gov.uk
  8. Office for National Statistics. Deaths involving COVID-19 by month of registration, UK. September 2021. ons.gov.uk
  9. Wang Y, Hunt K, Nazareth I, Freemantle N, Petersen I. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open. 2013.
  10. NHS Digital. Improving Access to Psychological Therapies (IAPT) Dataset: Annual Report 2019-20. digital.nhs.uk
  11. NHS Digital. NHS Health Check Programme, Patients Recorded as Attending and Not Attending, 2012-13 to 2017-18. October 2019. digital.nhs.uk
  12. Oliffe JL, Rossnagel E, Kelly MT, Bottorff JL, Seaton C, Darroch F. Men's health literacy: a review and recommendations. Health Promot Int. 2020;35(5):1037–1051.
  13. Abed MA, Kloub MI, Moser DK. Anxiety and adverse health outcomes among cardiac patients: a biobehavioral model. J Cardiovasc Nurs. 2014;29(4):354–63.
  14. House of Commons Library. Adult Obesity in England. commonslibrary.parliament.uk
  15. Office for National Statistics. Adult Smoking Habits in the UK: 2022. September 2023.
  16. UK Government. Health Matters: Harmful Drinking and Alcohol Dependence. gov.uk
  17. Towards a Healthier Britain. 2010.
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  20. Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int. 2019;124(4):587–599.
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  22. Martinez-Gonzalez MA, et al. Adherence to Mediterranean diet and risk of developing diabetes: Prospective cohort study. BMJ. 2008;336:1348–1351.
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  25. Fallah A, Mohammad-Hasani A, Colagar AH. Zinc is an Essential Element for Male Fertility. J Reprod Infertil. 2018;19(2):69–81.
  26. Palace VP, Khaper N, Qin Q, Singal PK. Antioxidant potentials of vitamin A and carotenoids and their relevance to heart disease. Free Radic Biol Med. 1999;26(5-6):746–61.
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  28. Toprak O, et al. The impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients. Clin Interv Aging. 2017;12:437–444.
  29. Siscovick DS, et al. Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease. Circulation. 2017;135(15).
  30. Bazinet RP, Layé S. Polyunsaturated fatty acids and their metabolites in brain function and disease. Nat Rev Neurosci. 2014;15:771–785.
  31. Dyall SC. Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front Aging Neurosci. 2015;7:52.
  32. Larrieu T, Layé S. Food for Mood: Relevance of Nutritional Omega-3 Fatty Acids for Depression and Anxiety. Front Physiol. 2018;9:1047.
  33. Cicero AFG, et al. Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer. Arch Ital Urol Androl. 2019;91(3).
  34. Wilt T, Ishani A, MacDonald R, et al. Beta-sitosterols for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2000;(2):CD001043.
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