Gym Owner Monthly

45 Plus — Men here’s what you need to do now to be healthier

In your twenties and thirties, you could get away with late nights and an extra pint of beer or glass of wine, skipping the gym and relying too heavily on takeaways at the weekend. But health problems have a habit of creeping up on you in midlife, and from your forties, it’s payback time — the pounds creep on, stress levels rise, and age and lifestyle start to take their toll. It is not too late to make amends, however. Here, experts share steps for men to improve their midlife health.
 

1. Keep an eye on your waistline

According to the British Heart Foundation, about four million men in the UK are living with circulatory or heart disease, and, as much as you might not want to hear it, your waist measurement matters. A waist circumference for men below 94cm (37in) is “low risk”, but 94-102cm (37-40in) is “high risk”, and more than 102cm (40in) is “very high risk” for the conditions, it warns.
 
A tight waistband can be a warning sign of other illnesses. A study of more than 218,000 British men aged 40-69 found that for every extra 10cm a man puts on around his waistline the chance of him dying from prostate cancer rises by 7 %. What’s more, research into mice on a high-fat diet suggests that abdominal obesity could be even more dangerous for men, who may be at a greater risk than women of developing cardiovascular disease and type 2 diabetes because of an expanding midriff.
 
“If you gain fat on your tummy and waistline, it is a sign that fat is settling around organs including your liver and pancreas,” says Roy Taylor, professor of medicine and metabolism at Newcastle University and the author of Your Simple Guide to Reversing Type 2 Diabetes. “Over time this can lead to insulin resistance and a greater risk of type 2 diabetes, so a tighter waistband is a clear sign you need to take action to reduce it through diet and exercise.”
 

2. Monitor your bathroom trips

Prostate cancer is the most common male cancer in the UK, with an estimated 52,300 new cases each year, and about 12,000 deaths. Some researchers have predicted that incidence rates will rise by 15% by 2038.
 
Men are at higher risk of getting prostate cancer if they have a family history of the disease (the hereditary BRCA2 gene mutation is a factor). It is more common with age, mainly affecting men over 50 (or if they are black, over 45), and the incidence is highest among 75 to 79-year-olds. One in eight men will get the disease at some point in their life.
 
In its early stage prostate cancer is often symptomless, and may remain so until the cancer has grown large enough to put pressure on the urethra, the tube that empties urine from the bladder. Although there is no national screening programme for the disease, the charity Prostate Cancer UK says that all men over 50 are entitled to request a blood test from their GP to measure levels of prostate-specific antigen (PSA). The test can pick up problems with your prostate before you have symptoms, but it’s also the case that many men with a raised PSA level do not have prostate cancer.
 
“It’s not a hugely reliable test, and PSA levels rise anyway as we get older, but it’s the best we have,” says Dr Jeff Foster, a GP specialising in men’s health and the author of Man Alive. “In the past five years, anyone with a PSA that is cause for concern has been referred for an MRI scan that will identify worrying hotspots. That is a big step forward as it reduces the need for random biopsies.”
 
Foster says that all men should look out for warning signs such as blood in their urine or semen, and a gradual change in bathroom habits. The prostate gland sits just below the bladder and the urethra runs through it. “Urinary problems increase as men get older, and this is commonly down to the effects of prostate growth, which happen with age,” Foster says. “As the prostate gland becomes enlarged it compresses, causing interrupted flow and an urge to urinate more often, making more frequent trips to the bathroom.” If this sounds familiar it might not be cancer but it does need checking out.
 

3. Pack in more plant-based foods

According to the British Nutrition Foundation, about one in three men meet the five-a-day advice for fruit and vegetable consumption, and the NHS Health Survey suggests that men typically consume 3.4-3.6 portions a day compared with the 3.7-3.9 portions consumed daily by women.
 
Increasing the amount and variety of fresh produce and whole grains you eat is one of the most important steps towards better health; a study of 400,000 British adults last year found that just two or more heaped tablespoons of vegetables a day were associated with a lower risk of cardiovascular illness. Meanwhile, researchers reporting at the 2023 American Society of Clinical Oncology conference in February found that of 2,000 men tracked for seven years, those with higher intakes of such foods had a 52% lower risk of prostate cancer progressing and a 53% lower risk of recurrence than those who ate the least plant-based foods.
 
In another large US study men who ate the most plants, fruit, vegetables and pulses had a 22%  lower risk of bowel cancer than those who ate the least.
 
“A variety of plant foods, from vegetables and berries to pulses and wholegrains, will provide a host of antioxidants and anti-inflammatory components that, along with fibre, help to reduce inflammation that can raise the risk of heart disease, prostate and other cancers as well as improving gut health and supporting immune health,” says Ian Marber, a nutrition therapist and the author of Man Food. “Eating more of them is a crucial step for men to take in middle age.”
 

4. The importance of cruciferous veg

Eating more vegetables, including carrots, beans and leafy greens as well as cooked tomatoes, that are rich in lycopene — a plant compound shown to reduce the risk of developing cancer — can cut the risk of prostate cancer, although researchers at the Fred Hutchinson Cancer Research Center in Seattle suggested that the biggest benefit may come from cruciferous vegetables such as cabbage, Brussels sprouts, broccoli and cauliflower. “Cruciferous veg contains high amounts of the phytochemical sulforaphane, which is known to have potent cancer-fighting properties,” Marber says.
 
But be careful of how much calcium you consume. Last year a study of more than 28,000 men suggested that those with a high calcium consumption of dairy foods had an increased risk of prostate cancer compared with those with a low dairy intake. “It seems that those with very high intakes of calcium, equivalent to two to three pints of milk a day, might be at greater risk of prostate cancer,” Foster says. “Stick to the recommended calcium amount for adults, which lies at 700mg — equivalent to a glass of milk and a small plain yoghurt — and avoid taking extra calcium supplements if you consume a lot of the mineral from dairy.”
 

5. Lose weight to enhance testosterone production

Levels of the male hormone testosterone climb during our twenties to a peak at the age of 30, but then decline by an average of 1 per cent a year, and along with it drop energy levels and a general zest for life. Early telltale signs of testosterone deficiency are mood, sleep or libido problems and weight gain, with more advanced symptoms including brain fog, gynaecomastia (or moobs), belly fat, a smaller penis and night sweats. To maximise your testosterone production as you get older you need a healthy diet — reduce sugary and ultra-processed foods while increasing healthy fats found in nuts, oily fish, avocados and eggs — and to lose excess weight.
 
“In men, a body fat percentage of 10-15%  is the optimum for testosterone production, and once higher than that production decreases, so keep tabs on body fat,” Foster says. “Don’t bother with herbal supplements that claim to be ‘testosterone boosters’ — there is no evidence they help.”
 
Exercise does help, and the latest data suggests the type of activity doesn’t matter as much as the intensity. “It used to be thought that only weight training made a difference to testosterone levels, but any exercise of a high enough intensity to make muscles fatigued and to raise your heart rate is beneficial, and you need to do 45 minutes of it three to four times a week,” Foster says. “Walking or a round of golf is not enough to make a difference and no amount will ‘boost’ levels to where they used to be when you were young.”
 

6. Aim for seven hours’ sleep a night

During midlife, stress mounts and sleep declines, with undesirable consequences. Researchers at the University of Cambridge suggest that middle-aged men should aim for seven hours sleep a night. In a study of nearly 500,000 UK adults aged 38-73 they found this to be the optimal amount for prime cognitive performance and mental health. Levels of depression, anxiety and general wellbeing were worse in people who reported sleeping for less time.
 
Barbara Sahakian, a professor of clinical neuropsychology in the department of psychiatry at the University of Cambridge and an author of the study, says too little sleep may prevent the brain from flushing out toxins and reduce the total amount of slow-wave, or deep, sleep associated with memory consolidation. “Getting a good night’s sleep is important at all stages of life, but particularly as we age,” she says.
 
Another study of 300,000 middle-aged participants from the UK Biobank database, published in BMC Medicine, found that men with sleep-related breathing disorders lost nearly seven years of normal heart health compared with those without breathing problems. Even general sleep loss caused by snoring, delayed bedtime, daytime naps and other habits was associated with a two-year reduction in normal heart health.
 
Getting enough sleep is important for testosterone production. “Studies have shown that just one week of too little sleep drastically reduces even a healthy young man’s testosterone production, and the effects could potentially be more significant for older men,” Foster says. “You need at least four hours of deep sleep, which is when your brain provides the luteinising hormone surge to trigger testosterone production.”
 

7. Don’t ignore erectile dysfunction

Some 50% of men experience erectile dysfunction (ED) at some point, yet, Foster says, “not nearly enough men discuss it with their GP because there is such stigma associated with the condition”. It is often dismissed as another inevitable sign of ageing, but sometimes there are more serious underlying causes. “Not all cases of ED are testosterone-related,” he says. “In fact, we consider it a symptom of cardiovascular disease until proven otherwise.”
 
The linings of the penile and coronary arteries are almost identical, and they are affected in the same way by cardiovascular risk factors such as smoking, obesity and inactivity. “Poorly controlled or undiagnosed type 2 diabetes also affects vascular, hormonal and neurological pathways required for an erection,” Foster says. “We estimate that in susceptible men there is a three-year window between the onset of ED symptoms and a cardiac event, so it is very important to seek medical advice and not just purchase over-the-counter medications to treat the symptoms of ED without addressing the cause.”
 

8. Find time for yourself

From data on more than 28,000 British adults collected over more than 30 years, researchers at University College London’s Centre for Longitudinal Studies found that today’s middle-aged men and women tend to experience peak stress, including symptoms of depression and anxiety, in their forties and fifties.
 
George Ploubidis, the professor of population health and statistics who carried out the research with colleagues, said that midlife “tends to involve a ‘peak’ in career and responsibility, reduced leisure time and changes to family structure such as empty nest syndrome and divorce”, all of which amplify stress.
 
“There can be a sense that life is moving fast, that you are losing your identity or that you are stuck in limbo,” says the chartered psychologist and psychotherapist Dr Julie Hannan, an expert on midlife issues. “The most important thing is to talk about this to someone and not to let the feelings of anxiety consume you. Finding time for yourself, whether that is in hobbies, new challenges or just some quiet time each day, is often the best first step.”
 

Rules for blasting that paunch

From mixing cardio with weights to getting enough sleep and cutting down on drinking, here’s what you can do to combat midlife weight gain
 
Yes, you must lift weights
There’s no getting away from this one: resistance training is essential and particularly important for warding off belly fat from your forties onwards. A 12-year study of 10,500 middle-aged men by Harvard University showed that those who did the equivalent of daily 20-minute weight training sessions gained less weight — and inches — around their middle than those who did just cardio training, although doing a mix of cardio and weights was reported to be the best overall approach.
 
Add sprints to your cardio
Jogging at a steady pace will improve your cardiovascular fitness and slowly burn fat, but to blast belly fat effectively you need to up the intensity. Injecting eight-second sprints into a 20-minute run three times a week was enough to produce a significant drop in trunk fat in a study of overweight men in their twenties who shed a total of 2kg of body fat and 17% of deep belly fat over three months using this approach. To achieve a similar reduction with continuous steady running would require jogging for seven hours a week — or an hour a day — for 14 weeks, the University of New South Wales researchers said.
 
Alternate weights and cardio sessions
Your best bet is to do cardio — running, cycling, swimming — one day and weights the next, according to Scandinavian researchers who found that alternating workouts produced the best belly-fat reductions in a group of 48 men. For six months participants were asked to combine cardio and resistance training in the same gym workout or to do them on alternate days, with a third group doing no exercise acting as a control. All exercisers did the same total volume of exercise and reduced fat by the end of the trial, but the men who alternated cardio and weights cut their belly fat mass the most, by an impressive 21%.
 
Eat more fibre
Few men consume enough fibre — most get about 18g a day — but increasing this to the recommended daily 30g with more wholegrains, pulses, fruit and vegetables in the diet may help to control weight gain. Research has shown that if fibre intake is below optimal, adding just 10g a day to the amount you consume can result in a 3.7 per cent reduction in the risk of gaining more belly fat over five years. Fibre also helps your gut microbiome to flourish — nutritionists at King’s College London have found a correlation between good gut bacteria and levels of belly fat.
 
Get more sleep
Even if you are diligent with exercise, the effects will be less pronounced if you don’t get enough sleep. Last year researchers at the renowned Mayo Clinic reported that even in lean, younger men restricted sleep led to more calories consumed, small increases in weight but a significant hike in fat inside and around the belly. Catch-up sleep — lie-ins and naps — did not reverse the belly-fat gains, at least in the short term, according to the scientists. Aim for a regular seven hours is the advice.
 
Cut down on beer and spirits
Almost one third of adults report drinking more than the recommended upper limit of 14 units of alcohol a week according to the charity Drinkaware, and those alcohol calories only add to belly fat. There are 7 calories per gram in pure alcohol, more than in plain carbs (4 calories per gram), and that’s before sugary flavourings and mixers are added. If you must have an alcoholic drink, make it wine — it was found to have the least damaging effect on the accumulation of belly fat in a study published in the journal Obesity Science & Practice.