Can you walk off Erectile dysfunction?

Researchers writing in the medical journal Urology examined questionnaires returned by over 15,000 aging men and found that moderate or severe sexual symptoms occurred in 20% of men 40 to 44 years and that significant symptoms increased with age up to 67% in the men 65 to 69 years. 1

Other researchers writing in The Journal of Sexual Medicine examined sexual function in older adults and noted that 41% of the men were sexually active with an average age between 75 and 87 (yes that says 87). The men who were not sexual active reported erectile dysfunction as the main reason why. Regardless the researchers concluded that desire for sexual activity remained high among men, despite substantial problems with erectile dysfunction. 2

Erectile dysfunction

It is important to understand that dysfunction is not an inevitable aspect of getting older. In fact, it’s more of a side effect of lifestyle than aging.

My initial advice to a man wanting to preserve or restore his sexual function is, instead of drugs, tie on your running shoes and start walking or jogging and change your nutrition. The old adage, “You are what you eat” rings true for sexual health and performance. Nutrition and exercise control the entire physiology of your body, and what you eat and do reflects in your ability to perform in bed.

Aging Men, Obesity, Metabolic Syndrome, Decrease in Total Serum Testosterone Levels
Researchers writing in the Journal of Urology say that their study “…demonstrated that aging men with obesity and the metabolic syndrome have a significant decrease in total serum testosterone levels compared to aging, metabolically healthy men.” Read more

Decreased Testosterone and Erectile Dysfunction
Researchers writing in the Journal of Urology say that their study clearly demonstrated a decrease in testosterone level throughout a 4-year follow up in patients with ED. Read more

Diabetes and ED
Researchers writing in the British Journal of Urology say that about 1 in 3 men newly diagnosed with diabetes had ED. Read more

Is Erectile Dysfunction A Marker For Diabetes?
Researchers writing in the Journal of Urology say that male dysfunction was “an observable marker of diabetes mellitus, strongly so for men 45 years old or younger and likely for men 46 to 65 years old, but it is not a marker for men older than 66 years.” Read more

1. Mäkinen JI, Perheentupa A, Raitakari OT, et al. Sexual symptoms in aging men indicate poor life satisfaction and increased health service consumption Urology. 2007 Dec;70(6):1194-9.

2. Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC. Sex after seventy: a pilot study of sexual function in older persons. J Sex Med. 2007 Sep;4(5):1247-53.

Aging Men, Obesity, Metabolic Syndrome, Decrease in Total Serum Testosterone Levels

Researchers writing in the Journal of Urology say that their study “…demonstrated that aging men with obesity and the metabolic syndrome have a significant decrease in total serum testosterone levels compared to aging, metabolically healthy men.”

Kaplan SA, Meehan AG, Shah A. The Age Related Decrease in Testosterone is Significantly Exacerbated in Obese Men With the Metabolic Syndrome. What are the Implications for the Relatively High Incidence of Erectile Dysfunction Observed in These Men? J Urol. 2006 Oct;176(4):1524-8
Read more

Abdominal Fat Strongest Indication of Health Risks

Researchers writing in the medical journal Obesity, say that waist measurement is one of the most useful indicators of health risk.

Shen W, Punyanitya M, Chen J, Gallagher D, Albu J, Pi-Sunyer X, Lewis CE, Grunfeld C, Heshka S, Heymsfield SB. Waist Circumference Correlates with Metabolic Syndrome Indicators Better Than Percentage Fat.

From the article abstract
OBJECTIVE: Percent fat is often considered the reference for establishing the magnitude of adipose tissue accumulation and the risk of excess adiposity. However, the increasing recognition of a strong link between central adiposity and metabolic disturbances led us to test whether waist circumference (WC) is more highly correlated with metabolic syndrome components than percent fat and other related anthropometric measures such as BMI. (Body Mass Index)

Waist circumference had the strongest associations with health risk indicators, followed by BMI. Although percent fat is a useful measure of overall adiposity, health risks are best represented by the simply measured WC.

Obesity and Decreased Hormone Production

Researchers writing in the medical journal Clinical Endocrinology say that “Obesity may predict greater decline in testosterone and SHBG levels with age.”

Derby CA, Zilber S, Brambilla D, Morales KH, McKinlay JB. Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study. Clin Endocrinol (Oxf). 2006 Jul 1;65(1):125-31.

From the study abstract:
Objective Cross-sectional data suggest that obesity, particularly central obesity, may be associated with decreased production of sex steroid hormones in men. However, longitudinal hormone data on men in relation to obesity status are limited. Previous studies have not consistently demonstrated whether sex steroids are associated specifically to body mass index or to measures of central obesity.

Our objective was to examine the relation of obesity and of central obesity to longitudinal change in sex steroid hormones in men.

Measurements Free and total testosterone (FT and TT), dehydroepiandrosterone sulphate (DHEAS), and sex hormone-binding globulin (SHBG) were assessed using standardized methods. Health behaviours and medical history were obtained by structured interview.

Repeated measures regression was used to describe trends in steroid hormones and SHBG in relation to obesity status, adjusting for age, smoking, alcohol, comorbidities, and physical activity.

Results: Obesity was associated with decreased levels of total and free testosterone, and of SHBG at follow-up relative to baseline. For any given baseline concentration of TT, FT or SHBG, follow-up levels were lowest among men who remained obese or who became obese during follow-up.

This was true for all three indices of obesity. Central adiposity was associated with lower DHEAS levels at follow-up, while elevated body mass index was not.

Conclusions: Obesity may predict greater decline in testosterone and SHBG levels with age. Central adiposity may be a more important predictor of decline in DHEAS than is body mass index.

Waist Size and Health Risks in 50-95 Year Olds

Researchers writing in the medical journal Diabetes Care say that while overall body fat and fitness levels are important in predicting health risks, it is your waist size or the measurement of abdominal obesity that is the still the measurement to assess health risk among older adults.

Racette SB, Evans EM, Weiss EP, Hagberg JM, Holloszy JO. Abdominal Adiposity Is a Stronger Predictor of Insulin Resistance Than Fitness Among 50–95 Year Olds. Diabetes Care 29:673-678, 2006

Excerpts From the study abstract
OBJECTIVE—Physical inactivity and increased adiposity contribute to insulin resistance; less is known, however, about the relative contributions of these factors in older adults. The aim of this study was to determine whether cardiovascular fitness, whole-body adiposity, or abdominal adiposity is the strongest predictor of insulin resistance into old age.

CONCLUSIONS—Adiposity and fitness continue to be significant predictors of insulin sensitivity into old age, with abdominal obesity being the most important single factor. These findings support the measurement of waist circumference to assess health risk among older adults.

Weight, Obesity, and Diabetes Research

Menopause and Obesity
After menopause, many women notice that their muscle-to-fat ratio tilts in favor of the latter and the battle of the bulge is increasingly difficult. All the hormones, especially estradiol and testosterone, can help tip the scale back in the right direction.

Estradiol, increases fat breakdown from body fat stores so that it can be used as fuel and increases basal metabolic rate, while testosterone has been shown to maintain muscle tone, volume, and strength, increase metabolism, and decrease body fat. In a 2000 study, featured in Menopause, estrogen supplementation had effects on body fat distribution in postmenopausal women that was associated with improved lipid parameters.

The Journal of Clinical Endocrinology and Metabolism reported that obese women given low doses of testosterone lost more body fat and subcutaneous abdominal fat, and gained more muscle mass than women who were placed on a placebo.

In a 2006 study, researchers writing in the medical journal Diabetes, Obesity & Metabolism found “HRT reduces abdominal obesity, insulin resistance, new-onset diabetes, lipids, blood pressure, adhesion molecules and procoagulant factors in women without diabetes and reduced insulin resistance and fasting glucose in women with diabetes.”

Women are not alone in the hormonal decline department. Men also experience a falling off of hormone levels. In my practice, I have found that most men over forty suffer from low levels of testosterone, a condition called andropause, or male menopause. Testosterone decline may be linked to many age-related symptoms like muscle weakness, bone loss, memory complications, weight gain and heart disease. As far as quality of life is concerned, in the absence of normal-to-high levels of testosterone, men suffer from mood swings, fatigue, and libido dysfunction

Not everyone will benefit from hormone supplementation. The goals, realities, and risks of hormone supplementation should be discussed, at length, with your physician prior to onset of treatment.

Insulin Resistance, Weight Gain Lead to Early Aging
When we eat, our bodies release insulin into our blood stream so that we can process glucose (sugars) from our foods to make energy, especially in our muscles. Glucose belongs in our cells and not in our blood. When it remains in our blood we produce more insulin. Increased insulin, according to many researchers, is the number one factor for accelerated aging.

Waist Size and Health Risks in 50-95 Year Olds
Researchers writing in the medical journal Diabetes Care say that while overall body fat and fitness levels are important in predicting health risks, it is your waist size or the measurement of abdominal obesity that is the still the measurement to assess health risk among older adults.

Exercise, Abdominal Fat, Insulin Resistance
Researchers writing in The Journal of Applied Physiology studied 16 obese men and women, about 63 years old, during a 12 week exercise program.

Low Gylcemic Index Foods for Weight Loss and Diabetes
Researchers writing in The Diabetes Educator say that incorporating more low-glycemic foods helped individuals with weight control and diabetes.

UCSD Study Sheds New Light on Insulin’s Role in Blocking Fat Breakdown in Patients with Type II Diabetes
“Chronically high levels of insulin, as is found in many people with obesity and Type II diabetes, may block specific hormones that trigger energy release into the body, according to researchers at the University of California, San Diego (UCSD) School of Medicine. Their findings, which may point to new approaches to developing improved treatment options for the disease…”

Be Active: Reduce Diabetes Risk, Live Longer
Researchers writing in the medical journal Diabetes Care, examined the relationship between active lifestyle, diabetes, and life expectancy.

Exercise, Diabetes, Diabetes Risk
Researchers writing in the Medical Journal Diabetes Care say patients may need more convincing that exercise assists in diabetes management and diabetes risk management.

Obesity and Decreased Hormone Production
Researchers writing in the medical journal Clinical Endocrinology say that “Obesity may predict greater decline in testosterone and SHBG levels with age.”

Abdominal Fat Strongest Indication of Health Risks
Researchers writing in the medical journal Obesity, say that waist measurement is one of the most useful indicators of health risk.

Sleep and Diabetes Risk in Men
Researchers writing in the medical journal Diabetes Care say that too little or too much sleep increases diabetes risk. The researchers say that men getting 5 to 6 hours of sleep a night were twice as likely to develop diabetes, men getting more than 8 hours were three times more likely to develop diabetes. They also noted that testosterone may be a factor in sleep on diabetes.

Testosterone, Diabetes, and Cardiovascular Disease
New research says Testosterone may have a protective role in the development of metabolic syndrome and subsequent diabetes mellitus and cardiovascular disease in aging men.

Middle Aged Men, Metabolic Syndrome, Stroke Risk
Finish researchers say that middle aged men with Metabolic Syndrome have twice the risk of suffering from a stroke. Read more

Metabolic Syndrome and Stroke
Researchers writing in the Archives of Internal Medicine say that preventing and controlling Metabolic Syndrome is likely to reduce risk of stroke.

Midlife Obesity Raises Risk of Alzheimer’s Disease Later

Researchers reporting at the American Academy of Neurology 58th Annual Meeting in San Diego this week say that midlife obesity raises the risk for Alzheimer’s.

From the American Academy of Neurology press release:
“People who are overweight or obese in their 40s have a greater risk of developing Alzheimer’s disease later in life, according to research that will be presented at the American Academy of Neurology 58th Annual Meeting in San Diego, Calif., April 1 – 8, 2006.

For the study, researchers followed nearly 9,000 people over a period of up to 30 years. The study participants were evaluated for overweight and obesity by measuring skinfold thickness below the shoulder and at the back of the upper arm. Those with higher skinfold measurements in their 40s were more likely to develop Alzheimer’s disease than those with smaller skinfold measurements.

Those in the highest group of shoulder skinfold measurements were nearly three times as likely to develop Alzheimer’s disease as those in the lowest group. For the arm measurements, those in the highest group were 2½ times as likely to develop Alzheimer’s as those in the lowest group.”

Read the entire press release at the American Academy of Neurology website

Research and Recent News on Alzheimer’s Disease

How Many Animals You Can Name In One Minute, May Help Determine Risk of Alzheimer’s Disease
Researchers reporting this past Tuesday said that the names of animals (such as Zebra and Giraffe) maybe used to determine who could be in the earliest stages of Alzheimer’s disease.

A study says that common words learned later in life typically disappear from the vocabulary of people in the early stages of Alzheimer’s Disease. An example given is with the names of animals.

Because we typically learn “Dog” and “Cat” in our earliest years, people in the early stages of Alzheimer tend to remember the words, yet other animal names learned later in life, (after age 5) were forgotten, (i.e., words like zebra and giraffe).

In one study, participants were asked to name as many animals as they could in one minute, “healthy” people could list 20-25. Alzheimer sufferer’s could only list 10-15, a significant drop in vocabulary.

You can read more at BBC

What Some Researchers Say You Can Do To Fight Off Memory Loss
Other researchers reporting Wednesday said that the tools to fight off memory loss associated with aging is to:

– Be physically fit
– avoid stress
– be socially active
– learn new things
– and “think young”

They also said that omega-3 (a fish oil) “may reduce the cell inflammation that triggers a decline in memory.”

Read More 

More On Insulin and Aging
A new study, to be published, says that high insulin levels, among both diabetics and non-diabetics, may contribute to Alzheimer’s disease.

To quote the authors of the study “Although this model has obvious relevance for diabetes mellitus, hyperinsulinemia and insulin resistance are widespread conditions that affect many nondiabetic adults with obesity, impaired glucose tolerance, cardiovascular disease, and hypertension. Our results provide a cautionary note for the current epidemic of such conditions, which, in the context of an aging population, may provoke a dramatic increase in the prevalence of AD (Alzheimer’s).”

You can read the entire article at the
Journal of Neurology

Obesity, High blood Pressure, High Cholesterol and Alzheimers Risk
Study published in October 10, 2005 issue of the Archives of Neurology

Midlife obesity puts you at a higher risk for dementia and Alzheimer’s disease than being at normal weight. The researchers noted: “Midlife obesity, high total cholesterol level, and high systolic blood pressure were all significant risk factors for dementia….”

Read the abstract

Examination of the effects of testosterone deficiency on Alzheimer’s Disease
Gouras GK, Hauxi X, Gross R, et al. Testosterone reduces neuronal secretion of Alzheimer’s -amyloid peptides Proc Natl Acad Sci U S A. 2000;3:1202-5.

Interpretation: Examination of the effects of testosterone deficiency on Alzheimer’s Disease

The researchers noted: “Increasing evidence indicates that testosterone, especially bioavailable testosterone, decreases with age in older men and in postmenopausal women….These results raise the possibility that testosterone supplementation in elderly men may be protective in the treatment of Alzheimer’s Disease

Hypoandrogen-Metabolic Syndrome in Men

Gould DC, Kirby RS, Amoroso P. Hypoandrogen-metabolic syndrome: a potentially common and underdiagnosed condition in men. Int J Clin Pract. 2007 Feb;61(2):341-4.

Researchers writing in the International Journal of Clinical Practice say Men with (Hypoandrogen-metabolic syndrome) and symptoms of androgen deficiency may be managed by, in the absence of contraindications, testosterone replacement therapy along with weight reduction and other measures to normalize glucose, lipid and blood pressure control.

The researchers noted that symptoms of androgen deficiency (hypoandrogenaemia (hypogonadism, hypotestosteronaemia) may be a common accompanying factor in men with the metabolic syndrome and when androgen deficiency and metabolic syndrome are present together “they may be considered as a specific entity, the hypoandrogen-metabolic (HAM) syndrome.”

The researchers concluded: “The prevalence of both hypoandrogenaemia and the metabolic syndrome increases with age and the clinician will frequently attend to men in their middle to advanced years with obesity, low androgen levels and metabolic syndrome.

These conditions place men at an increased risk of cardiovascular and coronary heart disease and type 2 diabetes and can be simply investigated with weight, waist and blood pressure measurement and blood sample analyses.

Men with HAM and symptoms of androgen deficiency may be managed by, in the absence of contraindications, testosterone replacement therapy along with weight reduction and other measures to normalise glucose, lipid and blood pressure control.”

Testosterone, Diabetes, Metabolic Syndrome

Recent research in the International Journal of Impotence Research say testosterone may have a protective role in the development of metabolic syndrome and subsequent diabetes mellitus and cardiovascular disease in aging men. However, clinical trials are needed to confirm this assumption.

Svartberg J.Epidemiology: testosterone and the metabolic syndrome.Int J Impot Res. 2007 Mar-Apr;19(2):124-8.

Low levels of testosterone, hypogonadism, have several common features with the metabolic syndrome. In the Tromso Study, a population-based health survey, testosterone levels were inversely associated with anthropometrical measurements, and the lowest levels of total and free testosterone were found in men with the most pronounced central obesity.

Total testosterone was inversely associated with systolic blood pressure, and men with hypertension had lower levels of both total and free testosterone.

Furthermore, men with diabetes had lower testosterone levels compared to men without a history of diabetes, and an inverse association between testosterone levels and glycosylated hemoglobin was found. Thus, there are strong associations between low levels of testosterone and the different components of the metabolic syndrome. In addition, an independent association between low testosterone levels and the metabolic syndrome itself has recently been presented in both cross-sectional and prospective population-based studies. Thus, testosterone may have a protective role in the development of metabolic syndrome and subsequent diabetes mellitus and cardiovascular disease in aging men. However, clinical trials are needed to confirm this assumption.

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