New approach to men’s health management

The current optimal solution for men’s health management is no longer a standardized template that requires uniformly “stop smoking and limit alcohol, do strength training three times a week, and sleep eight hours a day.” The core is Precise intervention by age and stratification + lightweight management of physical and mental synchronization ——This is the most practical direction I have summarized after spending 8 years in the clinical department of men's medicine in a tertiary hospital and following more than 1,200 men's health follow-up cases.

The 32-year-old Internet programmer Xiao Zhang who was treated last time fell into the trap of standardized templates. He read the "Men's Health Must-Do List" online, set an alarm at 6 o'clock every day and ran 5 kilometers, and squeezed an hour into the gym to work out after get off work. After three months of persistence, not only did he not feel any improvement in energy, but his uric acid level soared to 480 μmol/L. He had insomnia all night long, and even the frequency of sexual intercourse dropped by half. After the physical examination, he was very confused. He said that he had followed the standards, but why did he get worse as he practiced?

In fact, this is also a disagreement that has been quarreling for a long time in the sports medicine community: one group insists on the hard standard of "150 minutes of moderate-intensity exercise per week" proposed by the WHO, and believes that if this amount is not reached, it is not considered effective exercise.； The other school is the "micro-exercise adaptation school" that has emerged in recent years. A study published in the Journal of Sports Medicine last year showed that for working men who sit for more than 8 hours a day and have long-term high mental stress, doing office stretching and jumping jacks for 5 minutes three times a day can have 37% higher health benefits than forced high-intensity exercise. To put it bluntly, if you are already overwhelmed by KPIs, don't force yourself to be the "fitness king" and put extra burden on your body.

To be honest, I have stepped into this trap before. When I was 30 years old, in order to run a marathon, I practiced long distance for 2 hours a day. In the end, I developed fasciitis in my knees, which took me half a year to heal. Later, I changed to walking an extra 20 minutes to and from get off work every day, standing in the clinic writing medical records when I had nothing to do, and taking my children to hike a hill in the suburbs on weekends. Instead, my body fat rate has been stable at around 18%, and all indicators in my annual physical examination are normal.

Not only is the issue of exercise adaptation, many people's understanding of men's health is still stuck in the linear thinking of "replenishing what is missing", especially the matter of kidney replenishment, which has deceived many people. Zhou, a 40-year-old middle-level employee from a company, came for a check-up a while ago. He always felt backache and fatigue. He heard from a friend that middle-aged people need to replenish their kidneys, so he bought several thousand kidney-tonifying pills and took them for half a year. Later, his physical examination showed that his prostate-specific antigen (PSA) exceeded the standard. He was so scared that he thought he had prostate cancer.

There are also different views of the two schools here: Traditional Chinese medicine does say that "Yang Qi gradually declines in middle age, and it needs to be appropriately warmed and replenished." If the symptoms are correct, it can indeed improve energy.； However, statistics from the modern urology and nutrition circles show that 90% of middle-aged men with backache and fatigue are not "kidney deficiency" at all. They are either core muscle weakness caused by long-term sitting, or chronic fatigue syndrome. Indiscriminate consumption of warming products will increase the metabolic burden on the liver and even induce abnormal prostate hyperplasia. Later, the plan I gave Lao Zhou was very simple. He did plank support for 10 minutes every day to practice his core. Don’t go to the wine shop all the time on weekends. He would find a place to fish for half a day. He would come back for a review in two months. The PSA index dropped directly back to the normal range. He said that his waist was no longer sore, and he didn’t feel tired even after playing with his children for an afternoon.

The management priorities of different age groups are completely different. Don’t apply the habits of a 20-year-old to a 40-year-old body. Young men aged 20 to 30 always feel that they are young and can do no harm. Now among the cases we have followed up, the proportion of low serum testosterone in people around the age of 25 has reached 21%. Most of them are caused by staying up late, drinking ice drinks for a long time, and frequent masturbation. There are also differences in intervention at this stage: traditional men's medicine will recommend direct supplementation of testosterone undecanoate to quickly bring back the index, but the new view of the endocrinology department is that as long as there are no obvious problems of erectile dysfunction or seborrheic alopecia, there is no need to take medicine at all. First, adjust the work and rest to "try to go to bed before 12 o'clock, even if you only sleep for 6 hours." Eat oysters, pumpkin seeds and other high-zinc foods 2 to 3 times a week. The indicators can basically return to the normal range in about 3 months. The long-term benefits are much higher than taking medicine directly.

Men over 45 years old generally focus on indicators such as blood pressure and blood sugar, but tend to ignore the impact of emotions. I have met several retired men who were bored at home and had nothing to do. Their blood pressure fluctuated high and low. Even after taking antihypertensive drugs twice, they couldn't suppress it. Later, they followed our advice and went to the community to dance square dances and play chess with others. They didn't take any medicine, and their blood pressure stabilized. The current new consensus in geriatric medicine is that intervention in male menopause cannot rely solely on androgen supplementation, and the priority of "at least one social activity per week" is higher than adjusting medication.

Oh, by the way, there is another point that many people are embarrassed to mention: men habitually suppress their emotions and carry on when they are wronged or stressed. In the long run, the probability of suffering from peptic tract ulcers and coronary heart disease is 40% higher than that of women. Nowadays, the new method recommended by the Department of Psychosomatic Medicine is to "discharge emotions once a week". You don't have to drag people to complain. You can find a place where no one is around to yell a few words, punch a sandbag for half an hour, or even find a touching movie to cry. Don't always kidnap yourself with the idea that "men don't shed tears easily".

A while ago, I had dinner with some friends from the nutrition department and sports department. Everyone laughed and said that the current health science popularization has made people have obsessive-compulsive disorder. They can't eat or do this, and they only make life more tiring. In fact, it is really not necessary. Milk tea and beer are not completely off limits. Drinking them once or twice a week to satisfy your cravings is much less harmful than completely suppressing your desires and eventually overeating. After all, there is no standard answer to health management. If you feel comfortable and your physical examination indicators are normal, it is much more useful than following the templates on the Internet - your body is your own, and there is no need to make yourself miserable just to meet the "health standards" in the eyes of others.