Men’s Health Month: Getting Back to the Basics

You know the type. The macho guy who’s rough, tough, go-it-alone, leader-of-the-pack, help-not-wanted. Macho man may put off seeing a doctor for a checkup – because he thinks he’s invincible, doesn’t get sick, it’s a waste of time, only for the weak.

Physicians at the University of Maryland Medical Center say some men only give in when they have symptoms, when major treatments are required, or when preventive steps are more demanding. Even so, it’s never too late to start on the road to health.

June, Men’s Health Month, is a great time to focus on preventable health problems and encourage early detection and treatment of disease among men of all ages.

So, you’re out of shape?

Heart disease kills 1 in every 4 men in the US. One clue to heart health is endurance. Can you walk up two flights of stairs or four city blocks without stopping (barring traffic lights, etc.), or has there been a change in your activity level over the past 6-12 months? A man may shrug off the changes and blame them on being “out of shape,” but these changes could signal changes in heart health, says Michael Miller, MD, professor of cardiovascular medicine, epidemiology and public health at the University of Maryland School of Medicine and director, Center for Preventive Cardiology at the University of Maryland Medical Center.

Dr. Miller: “If the answer to both questions is ‘no’ (presuming they have no other limitations such as joint disability, emphysema, etc.), then their heart is considered to be in reasonably good shape and no further workup is usually necessary.  If the answer to either question is ‘yes,’ then further questioning and/or workup is indicated.”

The paunch and the pound

Dr. Miller: “I ask men what their weight and waist size was when they considered themselves to be in good physical health (often in their early-to-mid-20s). If either their current weight or waist size exceeds 10 pounds or 2 inches, the risk of Type 2 diabetes and heart disease begins to increase.  After checking for the major cardiovascular risk factors (cigarette smoking, high blood pressure, high cholesterol, diabetes), we make recommendations aimed at improving their cardiovascular health.”

Recommendations: Eat a big breakfast or lunch with a light dinner, have a snack between meals, take a walk after dinner, and relax 30-60 minutes before bedtime to increase the odds of getting at least seven hours of uninterrupted sleep.

All or nothing

Diabetes in men jumped 177 percent in the US from 1980-2014, fueled in part by weight gain and obesity. Shedding the pounds is often a struggle, but If your ideal, normal body weight is 180 pounds, and you’re 300, it may be unrealistic to set a goal of getting back to 180, says diabetes expert Kashif M. Munir, MD, assistant professor of medicine at the University of Maryland School of Medicine and medical director of the University of Maryland Center for Diabetes and Endocrinology.

Dr. Munir: “Of course, getting back to 180 is worth striving for, but to make differences that affect your risk for diabetes and heart disease, we’ve shown in studies that if you lose just five or 10 percent of your body weight, you can reduce those risks in a big way and improve your overall health, often within weeks.”

Exercise snacks. Diet is the main mechanism for losing weight, but the other side of the equation is exercise and doing more.

Dr. Munir: “What I tell people is to take exercise snacks. Instead of snacking on peanuts or cookies or whatever, do a 5-10 minute moderate-to-high-intensity workout. And if you can do that several times per day, all the better. Most people can spare 5-10 minutes here and there, so I tell people in the morning before you go to work, do a quick 5-minute jog, or something like that. At work, if you have a lunch break, go out for a walk, or get in some activity, and in the evening try to do the same thing.”

Lung Cancer: Put out the fire before it starts

Lung cancer is the leading cause of cancer death in Maryland men, yet men tend to wait longer to seek medical treatment for the condition than women, says Gavin L. Henry, MD, assistant professor of surgery at the University of Maryland School of Medicine and thoracic surgeon at the University of Maryland Medical Center.

Dr. Henry: “Many men who are referred to us have symptoms, but the referral is often a good sign because it likely means the cancer is in an early stage when there’s time to take action. As surgeons, we always say ‘the chance to cut is the chance to cure.’”

Annual lung cancer screening. Low-dose screening CT scans have become the standard for detecting early lung cancer.

Dr. Henry: “We recommend that men get a primary care physician, get regular checkups and screening, especially for men ages 55-70 with a significant history of smoking, (greater than 30 packs of cigarettes a year), and those with a family history of lung cancer.

Quit smoking. 80-90 percent of patients with lung cancer have a history of smoking.

Henry: “If a man is a smoker, the best thing he can do for himself is to quit. Many of my patients know smoking is bad for them. But it’s tough, it’s a habit. We recognize it’s a struggle, and we try to help with a variety of smoking cessation tools and techniques.

A man’s a man, and all that

Prostate cancer, the second leading cause of cancer death in Maryland men after lung cancer, is one of three major issues in urology for men, including sexual dysfunction and prostate enlargement, also known as BPH. “These three areas can disrupt men’s lives significantly; the incidence really starts to go up when men are in their 50s-60s-70s,” says Michael J. Naslund, MD, professor of surgery and chief of the Division of Urology at the University of Maryland School of Medicine and director of the Maryland Prostate Center.

Prostate cancer:  Cancerous cells develop in the prostate, one of the male sex glands. There’s not good data on preventing prostate cancer, and since there are no specific signs or symptoms, screening is the best way to detect it early. If it’s found, there are many treatment options, depending on health, age, expected life span, personal preferences, state and grade of cancer and the anticipated effects of treatment.

Dr. Naslund:  “When a man gets to age 50, he should be getting prostate cancer screening that includes a rectal exam and PSA blood test once a year, along with a blood and urine check. If there’s anything abnormal, then he’ll need further testing.”

Sexual dysfunction: It usually takes the form of erectile dysfunction, the inability to sustain or maintain an erection.

Dr. Naslund: “There are many things a man can do to prevent sexual dysfunction: maintaining good physical shape, not gaining a lot of weight will lower the risk of getting sexual dysfunction later in life. Not smoking is key: that helps prevents all kinds of vascular disease including erectile dysfunction. Eating smart, exercise, don’t smoke are the things men can do. Those three benefit men in a lot of other ways as well. As for treatment, pills are the first option and probably solve the problem three times out of four.”

Prostate enlargement (BPH): Partially block the bladder, resulting in a weak stream of urine and frequent urination

Dr. Naslund:  “Virtually all men get prostate enlargement, when compared to young men in their 20s. I would estimate that half of men don’t have any effects from it. They urinate normally and it never becomes an issue. Men often ignore symptoms and may not realize that treatment, if required, is less invasive with fewer side effects than it used to be.”

 

American Heart Health Month

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(L-R) Dr. Winakur, Ms. Robinson-Dawkins, Dr. Wen, Fellow Joyce Roller, Go Red for Women spokeperson, Ali Blais, Mayor Rawlings-Blake, Dr. Baker-Smith and Dr. Fisher.

By: Allie Ondrejcak, Communications Intern

Last week, Mayor Stephanie Rawlings-Blake held a Press Conference recognizing American Heart Month. The event featured: Dr. Leana Wen, Health Commissioner at the Baltimore City Health Department; Dr. Shannon Winakur, Medical Director at the Women’s Heart Center at Saint Agnes Hospital; Ali Blais, Director of Development for Go Red for Women; Alfreda Robinson-Dawkins, a heart disease survivor; and University of Maryland Medical Center’s Dr. Stacy Fisher. UMMC Cardiologist Dr. Carissa Baker-Smith was in attendance as well.

Dr. Fisher specializes in complex heart disease with special interests in adult congenital heart disease, heart disease during pregnancy and pulmonary hypertension. She spoke about several important issues at the conference:

  • The differences in heart disease between men and women
    • Heart risks and heart disease during pregnancy—because women are having children at older ages, and with complex heath conditions like diabetes and obesity, they are at a higher risk of developing heart disease
    • If you have a known condition, talk to your health provider before planning a pregnancy and to continue to discuss any symptoms you experience throughout
  • The importance of knowing your family history and heart-related sudden death.
    • it is important to be screened, and to have your children screened, for heart conditions
    • Being screened and knowing your history can help to prevent heart-related sudden death

In the United States, 1 in 3 women die of heart disease and it is the leading cause of death for both men and women. But the good news is 80% of heart disease and strokes can be prevented! The American Heart Association gives us 7 easy ways to lower your risk and improve your heath:

  1. Get Active
  2. Control Your Cholesterol
  3. Eat Better
  4. Manage Your Blood Pressure
  5. Lose Weight
  6. Reduce Your Blood Sugar
  7. Quit Smoking

Visit the University of Maryland Medical Center’s Heart and Vascular Center
for more information about our services and resources.

Also, check out UMMC’s “Never Skip a Beat” Heart Health Awareness Campaign for health tips, insights and information.

(L-R) Dr. Baker-Smith, Fellow Joyce Roller, Dr. Fisher and Dr. Winakur

 

Making Heart Health a Year-Round Priority

By: Hope Gamper, Editorial Intern

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February and American Heart Month are ending, but just because March is around the corner doesn’t mean you should stop thinking about keeping your heart in tip-top shape.

The American Heart Association (AHA), whose mission is to fight cardiovascular diseases and stroke, and the UM Heart Center offer a series of lifestyle recommendations for optimizing your heart health all year round.

Move More

Working out regularly is one of the best things you can do for your heart. Aim for at least 30 minutes of moderate physical activity at least 5 times a week (if you can’t do 30 minutes at a time, you can add up 10-minute sessions throughout the day).

Also try working in exercise to your normal routine:

  • Instead of driving to the store, walk or bike.
  • Park in a spot farther from your destination.
  • Keep dumbbells near the remote so you can stay active while watching TV.

Skip the Snacks

What you eat is just as important as what you do. Swapping out foods heavy with added sodium and fat for nutrient-rich foods can help you manage your weight, cholesterol and blood pressure. Here is a list of foods to fix and foods to nix.

Fix more foods high in vitamins, minerals and fiber, including:

  • Fruits and veggies
  • Whole grains – brown rice, quinoa, barley and buckwheat
  • Low-fat dairy products
  • Protein sources – poultry, fish and nuts

Nix processed foods and those that tend to be high in sodium and fat, including:

  • Sugary foods and beverages
  • Red meat
  • Deep fried foods or foods cooked in butter

Avoid Tobacco

Tobacco and other ingredients common in cigarettes frequently contribute to heart disease. Even secondhand smoke kills nearly 70,000 people each year.

The good news is that when you quit smoking you see short term benefits right away, and it only takes about 5 to 15 years to reduce stroke risk to that similar of a nonsmoker. There is still time to reverse the damage caused by tobacco and ensure that your heart keeps pumping for many years to come.

Click here for a list of Smoking Cessation Classes in your area.

 

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Heart disease accounts for 1 in 4 deaths each year, making these types of incremental changes vital to reducing your risk of heart related illness and keeping your heart well for all of life’s challenges, in February or any other month.

All About Triglycerides: An Interview with Dr. Michael Miller

Editor’s Note: A scientific statement published today in Circulation: Journal of the American Heart Association found that dietary and lifestyle changes significantly reduce elevated triglycerides, a type of blood fat, which is associated with heart, blood vessel and other diseases.

So what exactly are triglycerides, how significant are this statement’s findings and what specific steps can people take to reduce their triglyceride level and improve their heart health? Dr. Michael Miller, chair of the AHA’s statement committee, a cardiologist at the University of Maryland Medical Center and director of the Center for Preventive Cardiology at the University of Maryland School of Medicine, answers those questions and more to help you improve your triglycerides IQ.

As compared to lowering cholesterol, it sounds like lifestyle changes can go a long way toward lowering cholesterol levels.

Yes, lifestyle changes may only lower cholesterol 5-10% while they can lower triglycerides 30-50% and higher in some cases!

How significant are these findings, and why should people care and take action?

This is the most comprehensive statement on triglycerides and puts into perspective the important role that they serve as a barometer of our “metabolic” health. Optimal triglycerides suggest that fat is being effectively broken down whereas high triglycerides indicate abnormal processing, which may lead to excess fat in other tissues.

For example, excess fat in muscle may lead to insulin resistance and diabetes, excess fat in the liver may produce a fatty liver and excess fat in the belly may produce inflammation and increase risk of heart disease. In fact, a high triglyceride level may predict development of diabetes years down the road. Therefore, it is important that people pay close attention to their triglyceride level, especially because it can often be effectively treated with lifestyle measures.

What are triglycerides, and why are they important?

Triglycerides are simply our fats and high triglyceride levels in our blood tell us that our body is carrying around too much unhealthy fat. Too much unhealthy fat in our blood is associated with an increased risk of diabetes and heart disease.

Talk about the work your committee did, as well as the key findings.

Our committee of 15 men and women physician scientists evaluated more than 500  studies involving triglycerides during the past 30 years. In summary, our findings indicate that triglycerides are an important marker for heart disease risk.  High triglycerides may raise the risk of heart disease 20-50% and double the risk if accompanied by high levels of LDL (the bad cholesterol). High triglycerides are also associated with increased belly fat, high blood pressure, insulin resistance and low levels of HDL (the good cholesterol).

How are and how often should triglycerides be measured?

Screening levels can now be obtained in a non-fasting state and depending on the results will determine whether additional testing should be performed. For example, a normal non-fasting test (less than 200) may not need additional testing for a period of 1 year or greater, whereas high levels (200 or greater) should have a fasting test within a reasonable period such as 2-4 weeks.

It sounds like triglycerides are somewhat similar to cholesterol. Can you talk about that, as well as why the public is so familiar with lowering its cholesterol levels but not its triglycerides?

Cholesterol is a waxy substance whereas triglyceride is fat, but they are both connected by the lipoproteins that transport them to and from various body tissues. For example, triglyceride-rich lipoproteins include chylomicrons (that transfer triglycerides after a fatty meal) and VLDL (very low density lipoprotein) that transfers triglycerides from the liver. The triglycerides are broken down and stored in fat or used as an energy source in muscle. Cholesterol-rich lipoproteins include LDL and HDL and they transfer cholesterol to or from body tissues.

What are the current guidelines for triglyceride levels, and what is the optimal level?

In addition to the previous guidelines that define desirable levels (less than 150), borderline-high (150-199), high (200-499) and very high (500 and greater), we have now added the optimal level of less than 100.

What can people do to lower their triglyceride levels?

High triglycerides are very responsive to lifestyle changes. They include reducing weight if overweight by decreasing the total number of calories eaten daily, reducing simple sugars, especially fructose, decreasing saturated fat and eliminating trans fats. Physical activity, especially aerobic exercise, will also lower triglyceride levels.

Are there specific foods people should eat more of and avoid, and forms of exercise that are better than others?

Omega-3 fats that contain EPA and/or DHA such as found in fatty fish can lower triglycerides. Decreasing simple carbohydrates, saturated and trans fats are also recommended. Aerobic activity is also effective in reducing elevated triglycerides.