5 Steps for Optimizing Health during Men’s Health Month
Practical tips for the men in your clinic
June is Men’s Health Month and here are some interesting statistics about American men from the Centers for Disease Control and Prevention:
- 6% of males between the ages of 18-44 are in fair or poor health; this number increases to nearly 20% by ages 65-74
- The leading cause of death in males between the ages of 45-65 is cancer; this is replaced by heart disease in men ages 65 and older accounting for 25.5% of all deaths in this age group
- 8% of males 45-54 years of age are overweight or obese (as calculated by a BMI equal to or greater than 25), and 36.6% fall into the obese category with BMIs greater or equal to 30, (data from 2011-2014)
- 7% of males 55-64 years old are overweight or obese (as calculated by a BMI equal to or greater than 25); and 38.1% fall into the obese category with BMIs greater than or equal to 30, (data from 2011-2014)
- Nearly 17% of men over the age of 18 currently smoke 
As can be seen from the statistics above, there are steps that need to be taken to improve the quantity and quality of life of men in the United States. One of the first steps that can be taken is education within the practitioner’s clinic. Here are five actionable steps in getting male patients on track to a healthier future.
- Schedule an annual wellness visit
After all – if they don’t know it’s broken they can’t fix it! June is Men’s Health month, use this month to focus on the males in your practice by encouraging them to schedule their annual wellness visit. Picking a set month each year, whether it’s June or even their birthday month, will help your patients to more easily remember to schedule their annual visit to your office. Encourage them to keep the appointment by reminding them that annual wellness visits are important to:
- Identify problems that may lead to future chronic health conditions
- Discuss preventative lifestyle modifications including nutrition and exercise to reduce risk factors of chronic disease
- Order routine and age appropriate lab and diagnostic work ups
- Cultivate a relationship with their practitioner for future needs
- Optimize sleep
The National Sleep Foundation recommends adult males 26-64 years of age sleep 7-9 hours per night and 7-8 hours for males over 65 years of age. Less discussed however, is the quality of that sleep. It is estimated that 50-70 million Americans suffer from poor sleep yet only 20% ever discuss this with their providers. Sleep disturbances leading to less sleep and worsening quality of sleep has been associated with increased risk of cardiovascular disease, stroke and all-cause mortality and morbidity. Other risk factors impacted by sleep problems include weight gain, impaired glucose tolerance, higher pro-inflammatory state, higher cortisol levels and increased sympathetic activity.
If patients are having trouble with sleep here are a few tips to help them improve sleep quality and quantity:
- Reduce intake of alcohol, heavy foods, and processed carbohydrates at least 3 hours prior to going to bed. If patients are waking in the middle of the night feeling anxious or shaky consider hypoglycemia which may be supported through a small protein snack before bedtime.
- Turn off all screens (TV, iPads, cell phones, etc) at least 2 hours prior to going to bed.
- Use a fan or other white noise in the bedroom if outside sounds interfere with sleep
- Consider helpful sleeping aids including melatonin, lemon balm, skullcap, GABA, magnesium or valerian. There are a wide variety of combination formulas targeted to support different aspects of sleep disturbances including sleep initiation problems and sleep duration.
- Consider a referral for a sleep study if sleep apnea is suspected; it has been shown that treating obstructive sleep apnea can lead to improvements in certain testing parameters including homocysteine, glycemic and lipid markers. 
- Create an evening bedtime routine which they follow nightly. For example, have a cup of herbal tea, shower, get into bed, turn the lights down, read in bed (a book, not a screen), turn off light. Discuss steps which resonate with each patient to create a personalized and effective sleep program.
- Commit to regular exercise
Everyone knows exercise is one of the key pillars to long term health and wellness but in order for it to be beneficial it must be part of a routine plan. Work with your patients to discover their preferred type(s) of exercise and how often they can commit to these forms of exercise for the next 30 days. Implement the the S.M.A.R.T. (Specific, Measurable, Achievable, Relevant and Time-bound) goal process for exercise objectives and recommend your patients download apps to their smart phones to track fitness and progress. Research indicates the use of these forms of combined goal setting and technology positively impacts lifestyle modification outcomes. , , 
- Reduce alcohol consumption and make a plan to stop smoking
Alcohol consumption risks and benefits vary depending on the amount of alcohol consumed along with the individual’s genetics, nutritional status and ability to metabolize and excrete the substance. Practitioners should screen their patients for alcohol use while offering education regarding the list of chronic diseases, such as cancer, cardiovascular diseases, diabetes mellitus, liver failure and obesity which have been associated with chronic use of alcohol. 
Assess for family history of alcohol use, alcoholism and the above noted chronic disease processes. Patients may need guidance in reducing their intake which begins with education from their providers as well as putting support mechanisms into place including rehabilitation centers, counseling, support groups, stress modification, medication, liver and detox pathway support, exercise, dietary management and nutrient repletion.
According to the Centers for Disease Control and Prevention, smoking leads to more than 480,000 deaths each year in the United States which is nearly one in every five deaths. It increases the risk of death for all causes in both males and females and is the leading cause of preventable death in the United States. Armed with these statistics, each and every practitioner should take it up on themselves to help their patients create a smoking cessation plan as soon as possible. 
- Create a personalized nutrition and supplementation program
Nutrition should be the cornerstone for all health care and wellness programs. A nutritional program incorporates an approach appropriate for each individual considering their need for a specific range of calories, certain ratios of macronutrients, and optimal quantities of micronutrients and vitamins. Some common dietary approaches examples include Ketogenic, Paleo, and Mediterranean diets.
Nutritional supplementation is often utilized to augment the diet with missing or low levels of important components not being obtained through food alone. These gaps are often uncovered through routine and functional lab testing along with a detailed physical exam and medical history. Examples of common supplement recommendations include balancing the gut microflora through probiotics, reducing inflammation with turmeric and omega-3 fatty acids, and supporting cardiovascular health with CoQ10 and plant sterols.
An annual wellness checkup is the perfect time to “tune up” your patients with an in-depth look into the various lifestyle aspects of daily lives and an educational program geared towards teaching patients the importance of prevention and every day healthy choices.
 Centers for Disease Control and Prevention; Men’s Health. https://www.cdc.gov/nchs/fastats/mens-health.htm Accessed June 13, 2017
 National Sleep Foundation; https://sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times Accessed June 13, 2017
 Aziz M, et al. Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review. Journal of Atherosclerosis and Thrombosis. Vol. 24 (2017) No. 3 p. 208-226.
 Feliciano A, et al. Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apnea. Rev Port Pneumol (2006). 2017 Jun 5.
 Direito A, et al. Smartphone apps to improve fitness and increase physical activity among young people: protocol of the Apps for IMproving FITness (AIMFIT) randomized controlled trial. BMC Public Health. 2015 Jul 11;15:635.
 Higgins JP. Smartphone Applications for Patients’ Health and Fitness. Am J Med. 2016 Jan;129(1):11-9.
 Stephens J, et al. “Smart” Coaching to Promote Physical Activity, Diet Change, and Cardiovascular Health. J Cardiovasc Nurs. 2011 Jul-Aug; 26(4): 282–284.
 Zhou Y, et al. Alcoholic Beverage Consumption and Chronic Diseases. Int J Environ Res Public Health. 2016 Jun; 13(6): 522.
 Centers for Disease Control and Prevention; Health Effects of Cigarette Smoking. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm Accessed June 13, 2017