Friday, September 13, 2013

Low “E”

The “waddle” factor – obese Americans simulating mobility as they move from fast food outlet to grocery story – isn’t pretty. According to the Centers for Disease Control, 35.7% of all adult Americans are obese. Not just overweight: obese. Says the CDC: “The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.” The ads for weight control complain, “It’s not your fault” and offer everything from mail-order diets to surgical solutions, miracle appetite suppressants or metabolism accelerators to fat blockers.
Is there a ring of truth to that “It’s not your fault” mantra? I mean take a good look at lots of older Americans, even those who regularly go to the gym or actually work out regularly. Is there something about aging that makes getting that downward-shifting potbelly a normal part of the process? For men, the negative body transformation, reduction in strength and libido (hey, there is a little blue pill?!) is traceable to a significant and growing drop in testosterone as they age.
Estrogen, the female sex hormone, turns out to play a much bigger role in men’s bodies than previously thought, and falling levels contribute to their expanding waistlines just as they do in women’s.
“The discovery of the role of estrogen in men is ‘a major advance,’ said Dr. Peter J. Snyder, a professor of medicine at the University of Pennsylvania, who is leading a big new research project on hormone therapy for men 65 and over. Until recently, testosterone deficiency was considered nearly the sole reason that men undergo the familiar physical complaints of midlife.
“The new frontier of research involves figuring out which hormone does what in men, and how body functions are affected at different hormone levels. While dwindling testosterone levels are to blame for middle-aged men’s smaller muscles, falling levels of estrogen regulate fat accumulation, according to a study published [on August 11th] in The New England Journal of Medicine, which provided the most conclusive evidence to date that estrogen is a major factor in male midlife woes. And both hormones are needed for libido.” New York Times, August 11th.
Estrogen is actually produced as a by-product of testosterone production, and hence testosterone treatment can in fact produce more of that female hormone. The Harvard study examined 400 men between ages 20 and 50. “[The new] study [as reported by Dr. Joel Finkelstein, an endocrinologist at Harvard Medical School and the study’s lead author] provides a new road map of the function of each hormone and its behavior at various levels. It suggests that different symptoms kick in at different levels of testosterone deficiency. Testosterone, he found, is the chief regulator of muscle tone and lean body mass, but it takes less than was thought to maintain muscle. For a young man, 550 nanograms of testosterone per deciliter of blood serum is the average level, and doctors have generally considered levels below 300 nanograms so low they might require treatment, typically with testosterone gels.
“But Dr. Finkelstein’s study found that muscle strength and size turn out to be unaffected until testosterone levels drop very low, below 200 nanograms. Fat accumulation, however, kicks in at higher testosterone levels: at 300 to 350 nanograms of testosterone, estrogen levels sink low enough that middle-aged spread begins.” NY Times. Hey, it’s not just low “T”… it’s low “E.” Fix it, exercise or sit around on your duff, watch TV or chew the fat with a couple of friends!
I’m Peter Dekom, and this new study is about getting totally “waisted.”

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