Social networks, alcohol, seeing the doctor… Simple ways for men to live longer

The good news is that life expectancy for Irish men continues to improve. A 2018 report, Health in Ireland: Key Trends, notes that boys born in 2016 can expect to live for 79.9 years and girls to 83.6 years. The gap is narrowing, as male life expectancy increased by three years in the preceding decade, compared with less than two years for women.

The report states that a 40-year-old man can expect to live to 81, while a 65-year-old man can expect to reach his 84th year. These figures demonstrate that the best way to live a long life is by successfully getting older.

A total of 15,620 Irish males died in 2016. Four-fifths of all deaths occurred after the age of 65. While assiduous pension planning is an increasing national obsession, adding healthy years to our life is an equally achievable and worthwhile goal.

The Central Statistics Office lists 1,779 ways for men to die. Causes of death range from tularaemia, a tick-borne disease of central Europe with thankfully no deaths in 2016, to circulatory disease, with 4,768 deaths. The big killers are: cancers in their various forms; circulatory disease including heart attacks and strokes; and pulmonary diseases including chronic obstructive pulmonary disease (COPD) and pneumonia. All these conditions are influenced by lifestyle choices, which can delay onset and reduce the impact on healthy living.

Here are key steps that men can take to better health…

⬤ Stop smoking

Future generations will look back in disbelief at the lives lost and maimed by the convergence of nicotine addiction and capitalism. Some 22pc of adult men spend €4,000 a year to continue to smoke. They have a 50pc chance of dying from a smoking-related disease before the age of 65. All of the major killers of men are caused or worsened by smoking. It is a clichéd male trope that you are too old to quit. Benefits of cessation occur within days as carbon monoxide falls and oxygen levels increase by 10pc. Heart attack risks fall in the initial months and cancer rates likewise in subsequent years. Smoking reduces life expectancy by 10 years. The earlier you stop, the more years you recover, but even stopping aged 80 can produce some survival benefit. Stopping smoking aged 50 can reduce your chance of dying by 50pc.

⬤ Sleep it off

The 2017 book Why We Sleep cheerily informs us that men who sleep less than five hours per night have significantly smaller testicles than those who sleep for eight hours or more. Worse still are lower testosterone levels, poorer cognitive function, more cancers and more obesity during shorter lives. Long working hours, gruelling commutes and pervasive evening screen exposure all contribute to shrinking sleep times. Obstructive sleep apnoea is particularly prevalent in middle-aged males. If you have a shirt collar of 17 inches or more, snore prodigiously and are tired all the time, then you may wish to discuss this condition with your GP.

Regular reliance on sleeping tablets in older men is paradoxically associated with poor sleep quality and even an increase in death rates in some studies.

⬤ Take regular exercise

Regular physical exercise of any type, duration and frequency improves health and prolongs life. Increasing benefits occur with greater intensity; 72pc of Irish 20- to 24-year-olds report regular sport participation. Unfortunately, this falls off with age. The HSE recommends 150 minutes of moderately intensive activity per week; 40pc of Irishmen meet this target. It’s advisable to pick an activity you enjoy and are likely to stick with and increase effort over time to achieve a training effect. Benefits have been reported for simple tasks such as brisk walking and even, dare I say it, vacuuming.

Prolonged sitting is associated with early death, diabetes, cardiovascular disease and cancer. Regular exercise can mitigate this. Moderate physical activity in men over 50 in the Framingham Heart Study increased life expectancy by 1.3 years. More intensive exercise increased survival by 3.5 years. Exercise needs to include resistance training. With age, a man’s muscle mass decreases, facilitated by declining testosterone levels and an increase in body fat and frailty. Muscle mass predicts survival at all ages. Amongst men aged 24 and over, there is a 30pc decrease in mortality for those with the strongest hand-grip scores. Benefits are seen throughout life with weight training for 90-year-olds reporting benefit.

⬤ Take action if you are obese

Obesity is associated with circulatory disease, diabetes, cancer and death. The World Health Organisation predicted that Ireland will lead Europe in obesity prevalence by 2030; 43pc of Irishmen are overweight, while 25pc are obese. Fewer obese men than women actively try to control their weight. Set targets and manage diet and exercise. Every man should know their body mass index (BMI) and act to keep their score within the recommended 20-25. Simple BMI calculators are readily available online.

⬤ Watch your diet

Processed foods high in sugar, salt and saturated fats are a less healthy alternative to a diet rich in plant protein, carbohydrate and fat. Flavonoids rich in antioxidants and responsible for vibrant colours in fruit and vegetables significantly reduce cardiovascular risks. Omega-3 fatty acid from two portions of oily fish such as mackerel or salmon per week has a beneficial effect on cardiovascular health and reduces inflammation. A daily handful (30g) of nuts or seeds will reduce the risk of death from heart disease by 20pc.

⬤ Develop a healthy relationship with alcohol

The contribution of moderate alcohol intake to longevity is frequently reported and a source of comfort to those who imbibe. Irish men have yet to develop a healthy relationship with alcohol. We frequently and dangerously underestimate our annual consumption and levels of binge drinking. And remember, two-and-a-half bottles of wine or eight-and-a-half pints of beer spread out over a week are maximum recommended allowances and not targets to be met.

⬤ Remain social

Social networks provide purpose in our lives. Older men with two or three social networks live longer than those with no regular interactions. Altruism has an even greater effect, with those volunteering or providing support within their social network doubling their survival.

⬤ Take stock of your mental health

Optimism and resilience are both associated with longevity, particularly for older men. Self-care and attention to mental health issues can be underappreciated by men. Taking time to review goals and acknowledge successes fosters positive mental health.

Practised breathing provided by disciplines such as yoga have a calming effect on stress and blood pressure. As a quick exercise, try five deep purposeful breaths once or twice per day. Seeking help where appropriate is vital.

⬤ Don’t put off seeing a doctor

Studies of men’s health behaviour demonstrate that men present later and less frequently to doctors and other healthcare professionals. General health screening for diabetes, blood pressure and high cholesterol delays or reduces the severity of chronic diseases and their effect on health and long life. The national screening service offers bowel cancer screening to men over 60 and retinal screening for those with diabetes. Lung cancer, prostate cancer and testicular cancer kill far greater numbers and can be detected early in the appropriate setting. Oral health is important too, with poor oral hygiene increasing the risk of heart disease and inflammation.

While men in Ireland have made great progress in terms of length of life and burden of chronic disease, much more can be achieved. We can live longer, healthier and happier lives by taking positive actions now.

Dr Seamus Linnane (51) is a consultant Respiratory and General Physician. He practises at the Beacon Hospital, Dublin

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