Rising obesity among men takes toll on sexuality, prostate health

By Georgia Clark-Albert, Special to the BDN
Posted April 01, 2013, at 1:54 p.m.

It’s no secret that obesity is an issue in the United States, but what is surprising is the rising rate of obesity among men.

Between 1900 and 2011, overall obesity rates rose from 7 percent to 25 percent, according to Dr. Noel Richardson, director of the Centre for Men’s Health at the Institute of Technology. During the same time frame, the rate for men ages 51 to 64 increased from 10 percent to 42 percent.

Richardson theorizes that overall, men’s diets are less healthy than women’s, in that men eat fewer fruits and vegetables and more fried foods. Men are thought to associate extra weight with being stronger or more masculine and not necessarily a problem.

How do you know if you are overweight? The gold standard is BMI, or body mass index, but it doesn’t take into account muscle mass, so it isn’t always accurate for males who have a higher percentage of muscle. You can calculate your BMI by multiplying your weight in pounds by 703 and then dividing this number by your height in inches squared. A person who weighs 220 pounds and is 5 feet 1 inches tall would multiply 220 by 703 and divide that number by 70 times 70, resulting in a BMI of 31.5. A BMI between 25 and 30 is considered overweight and a BMI over 30 is considered obese.

Why is obesity so bad for your health? Excess body fat raises levels of LDL (bad) cholesterol and triglycerides and also lowers HDL (good) cholesterol. Obesity damages the body’s ability to respond to insulin, raising blood sugar and insulin levels, increasing your risk of developing diabetes. Obesity increases the risk of heart attack, stroke, hypertension, gallstones, osteoarthritis, obstructive sleep apnea, fatty liver, depression and cancer.

It is estimated that obesity and lack of exercise are responsible for about 1,000 American deaths each day. If this trend continues, obesity will soon surpass smoking as the leading preventable cause of death in the United States.

Men may be surprised to learn that obesity takes a particular toll on prostate health, male hormones and sexuality.

Obesity and testosterone

Testosterone is the major male hormone. Testosterone levels surge at puberty, peak in early adulthood, and after a few years of stability slowly decline in middle age. Since the drop in testosterone is gradual, about 1 percent a year, most men don’t notice the decline. However, obesity lowers testosterone levels.

A 2007 study of 1,667 men ages 40 and above found that for each one point increase in BMI, there was a 2 percent decrease in testosterone.

An even stronger predictor is waist circumference. A 2008 study of 1,872 men ages 30 and above found that a 4-inch increase in waist size raised a man’s odds of having a low testosterone level by 75 percent. By comparison, 10 years of aging increased the odds by only 36 percent.

Erectile dysfunction and reproductive problems

Men with erectile dysfunction often blame testosterone for the problem, but the hormone accounts for only about 3 percent of ED cases. Other common causes include heart disease and clogged blood vessels. Men who are obese also have an increased risk of ED. A man with a 42-inch waist is twice as likely to develop the problem as a man with a 32-inch waist.

Research has linked obesity to low sperm counts and reduced sperm motility.

Kidney stones

Kidney stones strike men twice as often as women, and obesity increases a man’s risk. Research from a Harvard study of almost 46,000 men ages 40 to 75 found that high BMIs and large waist circumferences are both linked to an increased risk of kidney stones.

Men who gain more than 35 pounds after age 21 are 39 percent more likely to develop kidney stones than men who stay slim. Men who weigh more than 220 pounds are 44 percent more likely to have stones.

Results from research in Europe and Asia show that overweight people form stones because of excess chemicals such as calcium that are dumped in their urine.

Prostate issues

As men get older, benign prostatic hyperplasia, or enlargement of the prostate gland, becomes more common — it also becomes more common with increased waist size. A Harvard study of 25,892 men found that waist circumference was strongly associated with a risk of developing benign prostatic hyperplasia symptoms. Men with waists of 43 inches or larger were 2.4 times more likely to need surgery for benign prostatic hyperplasia than men with waists smaller than 35 inches.

As the prostate gland enlarges, prostate-specific antigen levels rise. Obesity causes the prostate to grow, but it also lowers PSA levels. For each 5-inch increase in waist circumference, there is a 6.6 percent decline in blood PSA levels. However, men with higher BMIs have lower PSA levels not because their prostates produce less PSA, but because obesity increases blood volume, so PSA is more diluted in the blood.

Elevated PSA levels can indicate a higher risk of developing prostate cancer. Because obesity lowers PSA levels, it may be more difficult for doctors to use PSA measurements to detect prostate cancer in overweight males. Results from an American Cancer Society study of more than 400,000 men showed that being overweight increases a man’s risk of developing prostate cancer by 8 percent, being obese increases the risk by 20 percent, and being severely obese increases the risk by 34 percent. Additionally, overweight men tend to put off seeking medical care, and having a lower PSA reading could delay diagnosis.

If you’re a man and you’re overweight, don’t delay. Seek help today to improve your eating. Gradual changes work.

Georgia Clark-Albert is a registered dietitian and adjunct nutrition instructor at Eastern Maine Community College who lives in Athens. Read more of her columns and post questions at bangordailynews.com or email her at GeorgiaMaineMSRDCDE@gmail.com.

http://bangordailynews.com/2013/04/01/health/rising-obesity-among-men-takes-toll-on-sexuality-prostate-health/ printed on September 17, 2014