In a series of articles on men's health covering the spectrum from weight control, heart disease and diabetes to prostate cancer, Nutritionist, Belinda Rennie focuses on the main issues for men.

Being male is a health hazard. Statistics show that men are far less healthy than women with a considerably shorter average life span – seventy-five years compared with eighty-one years (Australian Bureau of Statistics, 1995). The big three - where men are at a much greater risk of dying than women - are heart disease, accidents and suicide and men are more likely to suffer from obesity, alcoholism, cancer and smoking-related diseases.

Underpinning these statistics are the bigger issues in men's health that often don't get talked about. Men need to take responsibility for their own health. This means a full, comprehensive, age-appropriate health check including a detailed medical history, thorough physical examination and blood and urine checks. A longer doctors consultation enables a more holistic approach taking into account not just body but mind and spirit. As Australian author of “Manhood”, Steve Biddulph writes, “the best predictor of life-expectancy in a man is whether he likes his job”.

Men's health is also about encouraging men to be more in touch with and to listen to their bodies and communicate feelings and emotions clearly and honestly. In this mindset, men would be more likely to do skin checks, report lumps or unusual changes in bowel motions or urinary difficulties and have them checked by their doctor.

Like women, men over the age of 40 need to keep a closer eye on their health especially if you have a family history of heart disease, diabetes or cancer. Some men are spurred into action when a colleague collapses from heart problems while others can bury their head in the sand and think they are immune to illness. Focussing on the positive aspects of maleness and how to get the best out of life whether it means living long enough to see your grand children or running around in the park with a football are some great motivators to take health seriously.

Here is a guide to the most important tests that should be included in an annual medical and what you can do to reduce your risk of disease. Ask your GP to explain your results and normal ranges.

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Heart disease

Knowing your blood pressure and cholesterol level as well as the good and bad fractions (HDL and LDL) and your cardiac risk ratio (total cholesterol divided by HDL) is important. Other tests such as C-reactive protein, fibrinogen, Lipoprotein a, and homocysteine levels can help give you a more detailed view of your coronary risk profile as these focus on inflammation and infection, blood clotting ability, genetic factors and nutritional deficiencies respectively (these markers will be covered in more detail in the next issue). An exercise stress test may be advised as it monitors how your heart functions under stress.

To reduce your risk of heart disease, follow a diet high in preferably organic vegetables and fruit, with wholegrains, pulses, fish, nuts, seeds and organic eggs. These are low in saturated fat and salt and high in fibre, essential fats and heart-protective antioxidants. Exercise, positive relationships and plenty of joy in your life are critical to keeping your heart healthy.

Cancer

Paying attention to any abnormal changes in your body is the key to detecting cancer early. Surveillance and self-examination are the mantras for men just as they are for women. Common cancers in men include lung, prostate, stomach, colon and testicles.

A routine stool test for fecal occult blood is an early indicator of problems in the colon and if you have a family history of colon cancer it is wise to have a colonoscopy to check for any abnormal changes. Reducing alcohol and red meat consumption, increasing fibre from fruit, vegetables and wholegrains helps to reduce the risk of colon cancer.

Smokers should consider having a spiral CT scan for lung cancer the most common cancer in Australia for both men and women. This is an advanced imaging technique that can pick up tiny lesions in the lungs. Research has shown that there are powerful incentives to quit. Within a year of stopping smoking, the risk of a heart attack falls to about half that of a continuing smoker. Within ten years, the risk of lung cancer falls to half that of a smoker.

There is even better news for those who manage to give up before they reach middle age. Even if someone has smoked since they were at school, if they quit by the age of 30, then the body can repair most of the damage that has been done to the lungs, and eliminate 90 per cent of the tobacco-related cancer risk. What is less widely known, however, is that quitting later in life also significantly reduces the risk of cancer and heart disease The more times you try to give up the more likely you are to succeed.

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Prostate cancer is the most common cancer in males in Australia , increasing markedly with age. If a man has any urinary tract symptoms it is useful to investigate with a digital rectal examination (DRE) that can feel any irregularities in the prostate, a small walnut shaped gland. Men over 50 years of age should receive a DRE and then based on the results and family history, a prostate specific antigen (PSA) blood test can be done. It can help men to take more control over their health if they understand these tests and the implications of the results.

Studies suggest that a low saturated fat diet high in fruits and vegetables with specific phytonutrients and antioxidants from vegetables such as the Brassica family (broccoli, cauliflower, cabbage, Brussels sprouts), legumes (chickpeas, soya beans, lentils and beans) and tomatoes can offer protection particularly for prostate problems.

Diabetes

Tuning in to bodily symptoms such as fatigue, increased thirst and urination and sores that don't heal well are some symptoms that can point to diabetes. Routine measurement of fasting blood sugar levels and then a glucose tolerance test, if indicated, is important to detect adult onset diabetes.

Prevention is a lifestyle issue focusing on moving your body more, reducing your abdominal fat and eating a low carbohydrate, low fat and moderate protein diet. Carbohydrates should primarily be low glycaemic index so they have a smaller impact on blood sugar levels and insulin.

To encourage greater awareness of men's health we need more role models that present a balanced image to children and adolescents of a healthy man drawing on the ancient Chinese tradition of yin and yang. Men can access both masculine and feminine traits in thinking, feeling and behaving and in doing so redress the imbalances in their health.

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