Men's Health - Dr. Stoutenberg


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Dr. Mark Stoutenberg of University of Miami Health System discussed men's health at the 2011 WellBeingWell Conference in Miami.

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Men's Health - Dr. Stoutenberg

  1. 1. Men’s Health<br />Above the Waist...<br />
  2. 2. Viagra – Other Uses?<br />Vasodilation in lungs<br />Performance at high altitudes<br />(Exercise) Performance enhancing properties??<br />
  3. 3. Overview<br />Cardiovascular Disease<br />Obesity<br />Physical Activity Patterns<br />
  4. 4. Cardiovascular Disease & Mortality<br />
  5. 5. Life Expectancy<br />Life Expectancy by Race & Gender (2007)<br />
  6. 6. Life Expectancy<br />Female-Male Life Expectancy Differences<br />
  7. 7. Leading Causes of Death<br />Heart disease: 616,067<br />Cancer: 562,875<br />Stroke (cerebrovascular diseases): 135,952<br />Chronic lower respiratory diseases: 127,924<br />Accidents (unintentional injuries): 123,706<br />Alzheimer's disease: 74,632<br />Diabetes: 71,382<br />Influenza and Pneumonia: 52,717<br />Nephritis, nephrotic syndrome, and nephrosis: 46,448<br />Septicemia: 34,828<br />
  8. 8. Leading Causes of Death<br />
  9. 9. Cardiovascular Disease<br />Cardiovascular disease is a general term that includes heart attacks, heart failure, stroke, and peripheral artery disease<br />Greek word for accumulation of lipid and hardening of artery<br />Previously, there was a “myth” that heart disease was a “man’s disease”<br />
  10. 10. Lloyd-Jones, D. et al. Circulation 2009;119:e21-e181<br />Copyright ©2009 American Heart Association<br />
  11. 11. A Closer Look at CVD Mortality<br />Lloyd-Jones, D. et al. Circulation 2009;119:e21-e181<br />Copyright ©2009 American Heart Association<br />
  12. 12. Framingham Risk Score<br />Age<br />Gender<br />Smoking<br />Cholesterol (Total & HDL)<br />Blood Pressure<br />Modifiable??<br />
  13. 13. Physical Inactivity & CVD<br />Physical inactivity carries similar risk for CVD as established risk factors such as blood pressure, cholesterol, and smoking<br />A 2.3% decrease in physical inactivity individuals (1980-2000)prevented or postponedapproximately 17 445 deaths (5%) dueto CHD in the U.S.<br />
  14. 14. Fitness & Mortality<br /><ul><li>Clearly, a strong relationship exists between fitness levels, CVD, and mortality.</li></ul>Relative Risk<br />Relative risk of all-cause mortality among individuals who achieved an exercise capacity of 5 to 7, 7.1 to 10, or >10 METs vs those who achieved an exercise capacity <5 METs<br />Kokkinos, P. et al. Circulation 2008;117:614-622<br />Copyright ©2008 American Heart Association<br />
  15. 15. obesity<br />
  16. 16. Obesity Trends<br />1990<br />1999<br />Distributions of Body Mass Index for Men and Women Aged 20 to 74 Years between 1976-1980 & 1999-2004<br />2009<br />Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The Epidemiology of Obesity. Gastroenterology. 2007. 132:6, 2087-2102.<br />
  17. 17. Obesity Trends<br />The Last Decade<br />Distributions of Body Mass Index for Men and Women Aged 40 to 59 Years in 1999-2000 and 2007-2008<br />Women<br />Men<br />Trends significant in men by:<br /><ul><li> All ages and racial groups (except Mexican Americans)</li></ul>Flegal, K. M. et al. JAMA 2010;303:235-241<br />
  18. 18. Mortality and BMI Category<br />Wei, M. et al. JAMA 1999;282:1547-1553<br />
  19. 19. Female Pattern of Obesity<br />Gynoid (pear)<br />Gluteofemoral region<br />More commonly seen in women<br />Insulin sensitive, lipolytic resistant<br />Metabolic “sink” for fat deposit<br />May have a cardioprotective effect<br />
  20. 20. Male Pattern of Obesity<br />Android (apple)<br />Fat deposited within and around the abdominal cavity<br />More common in males than in females<br />Considered far less cardioprotective<br />
  21. 21. Specific Fat Depots<br />Subcutaneous Fat<br />Visceral Fat<br />
  22. 22. Visceral Fat<br />Drain directly into the portal vein (liver)<br />Can put strain on liver (i.e., fatty liver)<br />Excess levels of visceral fat strongly linked to:<br /><ul><li>Type II Diabetes
  23. 23. CVD</li></ul>Affected by age, race, PA, gender and genetic influences<br />
  24. 24. Waist Circumference<br />Waist circumference is a measure of abdominal or central obesity<br />Gained attention for its relationship to the Metabolic Syndrome <br />Now one of the key defining criteria<br />Along with:<br /><ul><li>Central obesity
  25. 25. Impaired Fasting Glucose
  26. 26. Hypertriglyceridemia (High TGs)
  27. 27. Low HDL
  28. 28. Hypertension (High BP)</li></li></ul><li>Weight Loss<br />Diet<br />Exercise<br />or<br />1 Coke ≈ 100 Calories<br />1 mile ≈ 100 Calories<br />
  29. 29. Weight Maintenance<br />National Weight Loss Registry<br />To identify and investigate the characteristics of individuals who succeeded at long-term weight loss<br />Four key strategies for weight loss maintenance:<br />Self-monitor of eating habits and body weight<br />Eat breakfast every day<br />Low-fat, high CHO diet<br />Exercise every day!!<br />
  30. 30. Physical Activity<br />Patterns<br />
  31. 31. PA in Childhood<br />
  32. 32. PA in Adolescence<br />Prevalence of students in grades 9 through 12 who did not meet currently recommended levels of MVPA during the past 7 days by race/ethnicity and sex <br />Lloyd-Jones, D. et al. Circulation 2009;119:e21-e181<br />Copyright ©2009 American Heart Association<br />
  33. 33. PA in Adulthood<br />Carlson S.A. et al., Am J Prev Med, 2010; 39(4):305-13.<br />
  34. 34. Physical Activity & Survival<br /><ul><li>Such lower risks occur regardless of age and obesity levels</li></li></ul><li>Fit but Fat?<br />□ = fit <br /><ul><li>= unfit</li></ul>Examined the health effects of body composition among 21,925 men after taking cardiorespiratory fitness into account<br />Relative risks (RRs) of CVD and All-Cause mortality by cardiorespiratory fitness categories in men<br />Unfit men were the least-fit 20% of each age group and fit refers to all other men<br />Body fatness categories were:<br />lean (< 16.7%)<br />normal (16.7% to < 25.0%)<br />obese (≥ 25.0%)<br />Lee C D et al. Am J Clin Nutr 1999;69:373-380<br />
  35. 35. Fitness & Type II Diabetes (Women)<br />Sui, X., et al. Diabetes Care. 2008;(31):550-5.<br />
  36. 36. Some Anecdotal Thoughts…<br /><ul><li>Social Support Network
  37. 37. Companionship
  38. 38. Motivation
  39. 39. Solitude…
  40. 40. Enjoyment?
  41. 41. Long-term Commitment??</li></li></ul><li>Type of Physical Activity<br />Are there better patterns of physical activity to engage in?<br />
  42. 42. Taking Control<br />Self-Monitoring<br /><ul><li>Planning</li></ul>Steps per day?<br />Calories eaten?<br />Minutes spent being active?<br />Planning of weekly workouts?<br />Monthly plans and goals?<br />
  43. 43. Make an Exercise “Appointment”<br />Exercise!<br />Exercise!<br />Exercise!<br />Exercise!<br />
  44. 44. Enjoy Lunch!<br />