Men's Health

American Journal of Men's Health editor Demetrius Porche takes your questions about the health risks of being male, and how to reduce them.

Porche was online Tuesday, March 13, at 12:15 p.m. ET

A transcript follows.

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Arlington, Va.: I have a family history of arteriosclerosis. I've tried to reduce my overall cholesterol level as well as increase the HDL/LDL ratio. My current primary care physician wanted to put me on a drug to reduce my cholesterol immediately, even though I was only at the high end of the healthy range. He didn't even attempt to get me to change my eating habits or exercise regimen, he just wanted to push a new drug onto me. I know that studies have shown a strong and direct relationship between physician age and quality of care. Generally, a doctor is at her best about 5 years after finishing her residency. Her medical knowledge is still up to date and her skills are still sharp. This doctor seems to jibe with the study's results. According to a friend of mine, who's a much younger doctor, another remedy he suggested for a different condition is out of date by about 10 years.

I need to find a new doctor because my insurance has changed. I'm always hesitant to take recommendations from friends or family because it seems that the information they use to judge the quality of care they receive is skimpy at best. How much weight should I place on age when selecting a new doctor? What other information should I look at and where can I find useful information to help me make an informed choice?

Demetrius Porche: Thanks for you question. I would definitely suggest that you discuss with your health care provider their philosophy about including patients in their treatment recommendations. I would suggest that you select a provider that includes you in the decision making. This will provide an open conversation to permit you to ask questions and explore other options such as weight loss and exercise. The age of the provider is probably not as relevant as their knowledge level, competence and patient relationships. I suggest always securing recommendations about the selection of your health care provider. This includes interviewing the provider and asking critical questions before committing to a long-term provider.

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Annapolis, Md.: Do you support men using holistic medicine? If so, why do men fear or have a misunderstanding of using a holistic or natural medicine to rebuild the body?

Demetrius Porche: I think the use of holistic medicine is a positive complement to any regimen. I believe there is a lack of awareness and knowledge regarding this practice. I do support using holistic medicine that does have some evidence to support it's utilization. In addition, the utilization of holistic medicine should be disclosed and shared with your provider.

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Juneau, Alaska: Submitting a few minutes early...I'm a 39-year-old male who's had an extremely severe case of bulimia for several years. Because I'm fairly well off, I binge on $200-$300 worth of food on almost a daily basis. So beyond the obvious health concerns are the guilt and worries of ruining my financial security. The cause of it was primarily my marriage, involving a wonderful woman whose personality was so strong it dominated the relationship and I ended up feeling like I'd lost all control of my life.

That recently ended, on good terms thankfully, but there's one more huge problem with seeking help. I went through a lot of therapy as a youth in foster homes and, having read many of the same textbooks as them, have a lot of distrust for therapists. Also, some kind of lock-down in-patient treatment would likely just aggravate the feeling of having no control and feels like it wouldn't be a long-range solution. So the question I'm asking constantly is how do I get help under these circumstances?

Demetrius Porche: I think given your history, your best solution is developing a long-term relationship with a counselor. This relationship will provide support and serve as a network for you to utilize. You will need to consider a counselor or therapist that has experience with both behavioral, emotional, and social support.

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Charleston, S.C.: What foods should men older than 50 absolutely avoid?

Why?

Demetrius Porche: A balanced diet is the best selection. Persons over 50 should especially pay attention to ensuring that they daily vitamin amounts are consumed along with appropriate amounts of fiber. Food tolerance is individualistic and dependent on the individual. Well balanced meals consumed throughout the day are best.

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SW DC:: Hi there,

My husband has recently (within last year) been diagnosed with Type 2 Diabetes and is taking metformin and attempting to watch what he eats. He's cut out a lot of the "white items" (sugar, potatoes, rice, bread) but he is not the least bit interested in exercising. I have done research and found that walking, even for just 30 minutes a day, can significantly help his diabetes. How do I get him to work out?

Thanks!

Demetrius Porche: Studies have demonstrated that motivation can be stimulated by a man's partner participating in an exercise regimen with him. You can focus the event on spending time together and discussing issues while walking and enjoying the community. This takes the emphasis off of exercise and on spending time together.

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Southern Maryland: Decades ago, I asked my husband when did he last go to a doctor. The answer "Not too long ago." Well at this point, we had been married 2-plus years, dated 2-plus years prior and he had never been to a doctor since I knew him. We discussed that he had not seen a doctor in YEARS. He insisted he had. So I asked him the doctor's name. He gave me a blank deer in the headlights look. So he had not seen a doctor in 5-plus years, at least. I found and spoke to a family practitioner who became his physician for many years. Today, he sees the doctor, annually.

I tell wives to make sure they have plenty of life insurance on their spouses if their hubbies don't go to the doctor.

Demetrius Porche: Great. Men should be encouraged to routinely have a physical and annual examination.

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Norfolk, Va.: Three-part question:

Why is federal government spending on women's health issues so much greater than that devoted to men's health?

Why is there no dept. of men's health?

Finally, are feminist politics preventing a more equitable distribution of federal health dollars as well as stopping the establishment of a dept. of men's health?

Demetrius Porche: Unfortunately, I cannot definitely answer your question. However, there have been bills introduced in Congress to establish an Office of Men's Health. Some of the major barriers are a lack of awareness of need, a misunderstanding about what constitutes men's health, and concern that men's health will replace the focus or emphasis on women's health, and concern with having definitive outcomes.

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D.C.: Is the reason why women generally outlive men is because traditionally speaking, men have much more stress and responsibilities as the breadwinner, is it biological, or is it because they just want to die earlier?

Demetrius Porche: We are still exploring the answer to these questions. There may be a genetic and biological determinant, but it is definitely influenced by environmental factors. Men generally enter the health care system later with more advanced stages of an illness.

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Washington, D.C.: When and how often should men be going to see doctors? Which doctors? And at which ages? Like many men his age, my husband is 30 and hasn't been to see a doctor since high school, and only then for treatment of problems (broken bones, etc.) and not for preventative care. Now that we have the money, should he make one "big" visit to a doctor and then get on the once-a-year routine?

Demetrius Porche: I believe that men should routinely visit a health care provider for an annual examination, regardless of age. There are certain screening tests and preventive treatments that the health care provider will implement that are age dependent.

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El Dorado, Ark.: My 49-year-old husband will not take care of himself. He is quite overweight, has a family history of diabetes, and has just been diagnosed with high blood pressure. His doctor told him to lose weight and exercise, but he won't. We try to eat right, but even when we do, he eats too much. I think he likes being heavy. What can I do? Any books he would pay attention to? Another doctor or dietitian?

Demetrius Porche: I think you have a point that needs further exploration. He needs someone to help him identify what he values. Does he value health? Everyone does not value health. Understanding his beliefs and thoughts regarding his health may identify why he is not changing his behavior.

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Vienna, Va.: Advising men 40 and younger to get regular medical checkups sounds like a good policy for individuals. But is it a good policy for society as a whole?

Should we spend our medical resources testing a large group of people, most of whom are healthy?

Providing coverage for the millions of uninsured Americans seems a better use of our resources.

Demetrius Porche: Both are important. I believe we need to definitely ensure that all persons receive access to health care. However, this is a controversial issue. I do believe that if individuals do not remain healthy by seeking regular examinations at defined age points, this will also eventually impact society through many means.

Thanks to everyone for your interest in men's health and stimulating questions.

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