Real Men Eat Veggies (Too)!

When my oldest daughter was born in 1980 the prevailing philosophy was that there was no inherent difference between males and females. Give a little girl a truck, and she'll play with it as happily as she would a doll.

I obediently bought the trucks, but those bulldozers and backhoes sat there untouched (through two girls) until their baby brother arrived.

Men ARE physiologically different than women. Among other differences they are taller, heavier, have lower body fat levels, a higher percentage of lean body mass, a completely different hormonal profile, and obviously some different bodily organs. Not surprisingly, their disease risks and nutritional needs also differ from women. Men's eating habits also differ from women. Men frequently prefer the steaks, burgers, and eggs, putting fruits, vegetables, and vegetarian entrees in the same category as tearjerker movies and romance novels.

The biggest health risks for men are all the manifestations of cardiovascular disease (including heart attacks and strokes) and prostate cancer. One in five men suffers from some form of cardiovascular disease. Prostate cancer, the most common cancer in men, affects 180,000 new victims each year. Fortunately, similar eating patterns protect against both of these scourges.

The relationship between cardiovascular disease and diet is hardly a new discovery. Since the 1960's the medical community has advised that we limit intake of saturated fats and cholesterol. These dietary changes, along with cholesterol-lowering drugs and better management of heart attacks and strokes, have produced a steady decrease in cardiovascular mortality in the past couple of decades. But unfortunately this positive trend has been counterbalanced by dramatic increases in obesity and adult-onset diabetes. The current Atkins diet fad may eat away at hard-won low fat dietary habits.

Back in the 1970's cholesterol was the evil meanie extraordinaire. People exchanged eggs for Eggbeaters; butter for soft margarines. Now we realize the relationship between dietary cholesterol and heart disease is not so direct. Cholesterol is also manufactured internally and people differ in how they translate dietary cholesterol into blood cholesterol levels. (Though, yes, men have higher blood cholesterol levels than premenopausal women). Your total blood fat profile is more important than blood cholesterol in particular, and there appear to be "good" (HDL) and "bad" (LDL) forms of blood cholesterol. Whether or not those blood fats cling to your arteries, leading to cardiovascular disease, is dependent on diverse factors like exercise, stress and blood antioxidant levels.

We have yet to determine the perfect heart-healthy diet. At one extreme is the stringently low fat, high carbohydrate Ornish diet. At the other extreme are the high fat, low carbohydrate Atkins diet and its clones. Certainly the Ornish diet is more beneficial. Long term studies show that men following the Ornish diet lose weight, have lower blood fat levels, and lower rates of cardiovascular disease. In men already suffering from cardiovascular diseases the results are sometimes even more dramatic, with actual reversal of arterial damage. However the diet is very limiting, and many men find it difficult to follow for more than a few months.

The Atkins diet leads to significant weight loss, and decreased insulin resistance. In these ways it protects against cardiovascular disease. But in the long run the diet raises blood cholesterol and lipoprotein levels. And while temporarily a juicy steak may appeal more than a bowl of grains, this diet is also too limiting for most men to stick to. When a person on the Atkins plan reintroduces carbohydrates they usually regain all the weight they lost.

In a study recently reported in the American Journal of Clinical Nutrition, researchers analyzed data from 45,000 men. Using information from diet surveys completed by the men at the start of the study the scientists identified two major dietary patterns. One was a "prudent" diet high in fruits, vegetables, whole grains, fish and poultry, and the other one was a "Western" diet high in red and processed meats, whole fat dairy foods, and sweets. After eight years of study the scientists concluded that those who followed the "prudent" pattern were less likely to develop heart disease.

Probably the best plan is the Mediterranean diet, which allows more fat than conventional "prudent" plans, but largely of the monounsaturated kind (olive and nut oils), plus lots of grains, fruits, vegetables, and a small amount of meat and/or fish. Because this diet tastes so good (especially if you incorporate the Mediterranean seasonings) it's easy to adopt as a lifestyle.

Think in terms of intake of broad categories of food rather than specific nutrients. Counting every calorie and fat gram is another behavior pattern that's unlikely to last more than a few months. Besides, food interacts in complex ways and includes nutrients that haven't even been discovered yet.

A Mediterranean diet will also lower men's risk of prostate cancer. Overly high testosterone levels lead to prostate enlargement. A diet lower in red meat and dairy will lower testosterone levels to normal and keep this in check. Men who eat a lot of lycopenes, a phytochemical pleasantly found most abundantly in cooked tomato sauce (like pasta and pizza) have a significantly lower risk of prostate cancer. Watermelon, grapefruit, and guava are also good lycopene sources. Vegetables high in vitamin A, most notably apricots, carrots, cantaloupes, and strawberries, also help. Other possibly beneficial compounds include sulfurophane (found in broccoli) and genistein (found in soy products).

Essential fatty acids also exert a protective effect against both cardiovascular disease and prostate cancer. Cold pressed flaxseed oil is an excellent source of EFA's, and some medical professionals recommend a supplement of two tablespoons per day. However, it's easier and tastier to get EFA's from whole foods. Nuts such as walnuts and almonds are good sources, as are fatty fish such as tuna and salmon.