Male Mental Health: How Lifestyle Medicine Can Help
Understanding Male Mental Health In my podcast “Your Lifestyle Is Your Medicine,” I interview experts in the trenches from all the different facets of lifestyle medicine:
  1. Physical Activity
  2. Nutrition
  3. Sleep and Recovery
  4. Managing Toxins
  5. Stress
  6. Community
I recently spoke to Paul Weeden (Episode 29), an integrative therapist and embodiment coach who founded the company “Be Authentic on Purpose.” His company helps burnt-out and frustrated professionals to align with their authenticity and purpose. Talking to him made me reflect on the scale of mental health problems today, especially in men. Men generally don’t talk about mental health. The reasons are multifaceted and complex, ranging from cultural expectations to a lack of awareness. But this leads to a grim but inevitable conclusion, as seen in these statistics compiled by The Samaritans charity in the UK. In 2021,  The male suicide rate was 15.8 per 100,000, compared with 5.5 per 100,000 for women. That difference alone is stark, but for men aged 50 to 54, the rate was a shocking 22.5 per 100,000. They point to financial difficulties and loneliness as two of the drivers of the suicides in the older age group.  This isn’t a fun topic, but I believe that focusing on lifestyle medicine has a role to play in the management of depression, anxiety, loneliness, toxin abuse, and lack of sleep that could, at an early stage, underpin some of the epidemic of men’s mental health issues. What can we do about it? Physical Activity Research in the British Journal of Sports Medicine states, "Physical activity is highly beneficial for improving symptoms of depression, anxiety, and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders, and people with chronic disease. Physical activity should be a mainstay approach in managing depression, anxiety, and psychological distress.” [1]  It’s free, doesn’t require much time, doesn’t involve medication, and, to a large extent, anyone can do it. Plus, physical activity (I’m not just talking about exercise here) has many other benefits, from increasing muscle mass, which has been associated with living longer, to reducing heart disease and cancer.  Nutrition It’s straightforward for most people to see how poor nutritional habits can lead to physical degeneration, but it's less easy to see the connection between poor diet and mental health. However, standard nutritional deficiencies are found in people who suffer from depression, and reversing those has been shown to have good results. For example, increasing levels of omega-3–3 fatty acids, vitamin B (e.g., folate), and magnesium in the diet have all been shown to help with depression. [2] Sleep and Recovery Links between sleep and depression are strong. About 75% of depressed patients have insomnia symptoms, and sleeping too much is present in about 40% of young depressed adults and 10% of older people. [3] Good sleep starts in the morning; simply getting sunlight into your eyes on waking helps reset the balance of some of the hormones that influence sleep (melatonin and cortisol). This then sets you up for a good night's sleep, assuming that good ‘sleep hygiene is being practiced…no screens in the bedroom, no coffee after 12, not eating late, etc.  Toxins Most people will think about toxins and abuse of toxins and believe it doesn’t apply to them. Well, that’s simply not true. Modern life bombards us with chemicals every day, from pesticides to plastics, and the toxic loads on our bodies are only increasing. However, with adequate water, exercise, and clean food, our bodies are pretty good at dealing with it. But we humans have a knack for making things worse than they need to be… For example, one of the most avoidable toxins is alcohol, yet it is part of the social fabric of many cultures. Even though alcohol may temporarily decrease anxiety symptoms, it invariably increases depressive symptoms [4], becoming a vicious circle of self-medication and worsening symptoms.  The key here is to seek help. Most men don’t want to admit they are self-medicating, but plenty of support networks exist if they are honest with themselves. Stress Management We all experience stress, but how we manage it varies greatly. Our ability to cope with stressful situations can be linked to previous negative factors such as adverse childhood environments, negative emotionality, and prior psychiatric history [5]. However, there is a flip side to that coin, and in recent years, researchers and clinicians have suggested that positive psychological characteristics may be a protective factor for depression. For example, if a person has a positive outlook on life, is satisfied with things, and has a sense of purpose, this can buffer them from the effects of stress, and in turn, this can protect them from depression [6]. Researchers call this protective factor a good sense of well-being. With this in mind, employers can play a vital role in male mental health by implementing stress-reduction strategies, encouraging work-life balance, and fostering a supportive environment where people’s well-being is nurtured.   Community and Relationships In his TED talk [7], Robert Waldinger, the director of the Harvard Study of Adult Development, one of history's most comprehensive longitudinal studies, highlights something exciting.  For over 75 years, they have tracked the lives of 724 men, and during that time, they have asked them about their lives, health, and experiences while collecting objective data like blood tests and brain scans. Interestingly, Waldinger noted that the most critical factor in predicting the health of an 80-year-old was not the blood markers when they were 50. Still, the quality of their relationships, and conversely, he noted that loneliness kills. People who are more connected to family, friends, and community are happier, healthier, and live longer than those who are not. In midlife, it’s easy to give up on community and relationships. Men commonly overwork, leading to alienation from family and friends and divorce. It sounds cliche, but joining clubs and getting hobbies (even better if they involve movement) can add years to your life.   A Path Forward For me, mental health is a topic I’ve always been inclined to avoid. I felt I didn’t have the experience or skill set to help people suffering from depression or anxiety. However, the more I learn about men my age suffering in silence, the more I want to help. I believe that the six pillars of lifestyle medicine provide a solid foundation for people suffering from anxiety and depression, and with coaching, it is possible to reverse the symptoms and, by association, improve relationships and families while having that positive change ripple out in communities. If this resonates with you, please email me at ed@edpaget.com, and we can have a quick call to see if lifestyle medicine coaching would be a good fit for you.   Sources:
  1. https://bjsm.bmj.com/content/early/2023/07/11/bjsports-2022-106195
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181883/
  4. https://www.healthline.com/health/mental-health/alcohol-and-depression
  5. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0067395#pone.0067395-Piccinelli1
  6. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0067395
  7. https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness?language=en
Resistance Training Makes You Look Younger
With the aid of powerful pharmaceutical drugs, people are living longer. I think we can all agree on that.  But the drugs don’t add health span (the number of healthy years a person has). I don’t think that keeping people alive for longer in nursing homes with pharmaceuticals is what people get excited about when we think about living longer.  By contrast, exercise is one of the most effective ways of adding healthy years to a long life. It can do this in several ways, from reducing cancer risk to improving cardiovascular health. But you may not know that exercise can improve skin health, one of the most visual external markers of age.  Think of the skin of someone who smokes a lot, drinks a lot, doesn’t eat well, and never exercises compared with the skin or someone who is very health conscious. There’s a difference, right?  That’s why skincare is a multi-billion dollar industry because so many of us want younger-looking skin.  However, can we have younger-looking skin without applying products or taking drugs?   The answer is YES.  Exercise has been shown to help skin health, but what type is best? A recent study out of Japan compared aerobic training (an activity previously linked to anti-aging activity in the skin) with resistance training in 61 healthy sedentary middle-aged Japanese women over 16 weeks.  Both forms of exercise significantly improved skin elasticity and upper dermal structure, and resistance training specifically improved dermal thickness, while aerobic exercise did not.  This is important because dermal thickness, which is the thickness of the skin, decreases as we age, so improving it is a good thing.  Also, resistance training helps decrease inflammation and increase muscle which has long been linked to longevity! Source: https://www.nature.com/articles/s41598-023-37207-9?_kx=t4If0nOfpNdZ-HC1xYBPDO82IcYl_wFMhDzAApaDTNA%3D.HKMsXE
Decreasing LDL Cholesterol Without Medication
I recently took a blood test and was surprised I had high LDL cholesterol.  But I’m a 45-year-old male, and it is pretty standard for men to get a shock diagnosis this out of the blue. Sometimes it’s high blood pressure, but most of the time, it’s a cholesterol problem. This made the results of my blood test all the more surprising. I practice the lifestyle medicine I preach. My diet is pretty clean; I manage my sleep, exercise, and manage my stress.  Stereotypically high cholesterol is attributed to people a little older, overweight, and who generally eat poorly and don’t exercise. In the UK, high cholesterol affects 60% of people and has been attributed to about 6% of deaths yearly.  Cholesterol is a fatty substance almost every cell uses in the body. The liver mainly makes it and recycles any excess. It’s pushed out into the blood, where the body uses it. However, sometimes the balance between production and recycling is unbalanced. This can lead to an increase in cholesterol, and the current theory is that the rise in LDL can lead to excess being deposited in the arteries leading to narrowing blockages and heart attacks.  A 2019 landmark study published in The Lancet medical journal involving data from nearly 400,000 people in 19 countries established for the first time that levels of non-HDL, or “bad cholesterol,” in the blood are closely linked to the risk of heart disease across the entire life course, and there’s now a growing school of thought that young people should know their cholesterol levels earlier so they can make suitable lifestyle adjustments or take statins. These drugs have been proven to reduce cholesterol. Now there is some controversy here. Some doctors think that the ‘war against cholesterol’ might be motivated by the profits of the drug companies, that they aim to get everyone on statins, and that the evidence to say that high cholesterol is linked to heart disease is shaky. You can learn more about this topic with the book “The Great Cholesterol Myth” by Jonny Bowden and Stephen Sinatra. Personally, I’m not a fan of any pharmaceutical intervention and don’t like the side effects of statins, so I prefer to fix things naturally where possible. Also, I’m not talking about total cholesterol, just LDL, as HDL cholesterol has been given the all-clear when it comes to heart disease.  In the UK, the guidelines for LDL are:
  •  3mmol/L or less for healthy adults
  •  2mmol/L or less for those at high risk
In the US, they use milligrams per deciliter and recommend your blood levels to be 100mg/dL or below, which is 2.6 mmol/L  My results were 136mg/dL on Jan 5th, 2023, and reduced by 42% to 78mg/dL in March 2023. Even though the body produces cholesterol, our diet can affect it. A diet high in saturated fat, not exercising, being overweight, smoking, and drinking alcohol can increase cholesterol.  None of those things applied to me, but the Inside Tracker App noted that cooking with a lot of coconut oil can lead to increased LDL. I use coconut oil in my cooking, so one of the first things I did was cut that out. Then I returned to my osteopathic routes and thought about what naturally removes cholesterol from the body. It is recycled and removed by combining liver and bile stored in the gall bladder. I started eating a small salad containing bitter greens to stimulate the liver bile before my main food. I also put olive oil on the salad. The bitter green stimulates the liver to produce bile, and the fat in the olive oil stimulates the gall bladder to contract and release more bile.  This primed my digestive system to be more efficient at removing excess cholesterol. Interestingly eating a small salad before the main course is how many European countries traditionally eat, and they know this helps their digestion which is why they do it. Those two simple lifestyle changes were enough to reduce my LDL by 42% in 3 months, the same if not more than the decrease most people see with statins without any side effects. If you have high cholesterol and want to change things naturally, send me an email, and we’ll discuss your unique situation and make a plan for you to lower it without having to take statins.  Sources:  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32519-X/fulltext
Lifestyle medicine: How to Live a Longer, Healthier Life
As an osteopath passionate about aiding individuals on their journey to recovery from various health issues and injuries, I have always been deeply committed to the idea that holistic wellness extends beyond just the physical aspects of our bodies. Drawing from my background in sports science and personal training, my approach to helping people attain better health has evolved into a multifaceted methodology encompassing physical and psychological dimensions; we can also call this lifestyle medicine coaching.  Over the years, I've been shaping my practice using a wide range of techniques, including thorough physical assessments, comprehensive case histories, and targeted interventions to facilitate the healing process. However, I desired to delve even deeper into the realm of healthcare, which led me to explore the fascinating field of lifestyle medicine. In pursuit of expanding my coaching capabilities to offer a more comprehensive approach to healing, I recently enrolled as a Hintsa Performance Coach. They are a high-performance coaching company based in Finland. The company started life by offering comprehensive support to Formula 1 racing drivers but has since taken this knowledge and learned how to provide it within other professional sports environments and to people in the workplace. Hintsa's holistic philosophy resonated with me, as it centers around a metaphorical wheel with the core or purpose of one's life at its epicenter. This essence represents the discovery of one's life purpose—a process that involves introspection and self-inquiry, guided by thought-provoking questions such as:
  1. Who are you at your core?
  2. What do you want?
  3. Are you in command of your life?
The journey to understanding one's purpose paves the way for cultivating habits and practices that foster health across many areas of a person's life. This wheel extends outward, representing key areas of focus that makeup lifestyle medicine:
  1. **Nutrition**: Nourishing the body with balanced, wholesome foods.
  2. **Biomechanics**: Ensuring optimal physical alignment and movement mechanics.
  3. **Mental Energy**: Optimizing cognitive abilities and emotional well-being.
  4. **Sleep and Recovery**: Prioritizing restorative sleep patterns for regeneration.
  5. **Physical Activity**: Engaging in suitable exercises for overall fitness.
  6. **General Health**: Taking proactive measures to safeguard well-being.
For example, using this approach, I lowered my LDL cholesterol by 58 points, from 136mg/dL (potentially unhealthy)  to 78mg/dL, optimized for my age and sex, and this took just three months. There are many other small changes that I've made in my life after I applied the principles of high-performance coaching using the lifestyle medicine model to myself, and I summarize many of them in this video: [embed]https://youtu.be/KRYUucHrOt8[/embed] My journey as an osteopath has evolved into a holistic pursuit of well-being, encompassing the physical aspects and the intricate interplay between the mind, body, and purpose. The integration of lifestyle medicine principles, as exemplified by Hintsa's philosophy, has changed my life. Still, through coaching my clients, I have enabled many of them to start these transformative journeys of self-discovery and healing themselves. Whether they come to me because of a recent health scare, high cholesterol is the most common reason, or they just want to get rid of chronic pain, I use this integrated approach of science-backed insights to help them reach their goals and ultimately add health span to their lifespan. Find out if lifestyle medicine coaching is for you. Email me at ed@edpaget.com, and we can jump on a quick call to see how I can help you.