ORTHOPAEDICS

40 to 50

This is a decade where the bone turnover starts reducing. So, both mechanical and degenerative changes take place. The degenerative bone diseases include mild osteoarthritis of weight-bearing joints like knee and hip. Spine related degenerative changes include spondylosis (arthritis spurred by wear and tear to the spine) which can be associated with bad sitting posture at work.

Vitamin D deficiency is another prevalent issue at this age in this part of the world.

Start consulting your doctor for periodic checkups even if there are no symptoms. People with developing osteoarthritis should avoid sitting on the floor cross legged; avoid squatting and limit the usage of stairs which can aggravate the degenerative changes.

The importance of a good diet and proper exercise has to be stressed for strengthening of core muscles.

50 years and above

In this phase of life, bone and muscle degeneration can be progressive, leading to osteopenia (low bone mineral density), osteoarthritis and stress fracture. Care should be taken to maintain good Vitamin D level and bone strength. As the saying goes, mobility is life. More physical activities, right exercise and a good diet will induce good bone strength naturally and fewer metabolic problems.

Source: Dr Prem James Charles, medical director, specialist orthopaedic surgeon, Aster Specialist Centre for Orthopedics and Physiotherapy

NUTRITION

40 to 50

Life gets busy for most men during this phase of life and healthy eating is often way down in the list of priorities. A diet rich in antioxidants may help protect against some health problems such as heart disease, Alzheimer’s, cataract and certain types of cancer.

After the age of 40, the metabolic rate drops. People in this age group experience dietary issues due to a change in hormone levels and poor food choices, combined with a lack of exercise. Excess weight, central obesity is a risk factor for heart disease, diabetes, and osteoarthritis. The longer you wait before you tackle the problem the harder it becomes to cut down on the extra pounds even before it becomes a serious problem.

[Anorexia among men: breaking down an eating disorder stereotype]

Include foods high in vitamins C and E, and antioxidants that will protect free-radical damage. Free-radical damage is thought to contribute to ageing and many chronic diseases. Consumer more of locally available produce than packaged.

Excellent sources of vitamin C include red and green peppers, citrus fruits, kiwi, broccoli, Brussels sprouts, strawberries and tomato juice. Vitamin E is plentiful in wheat-germ oil, sunflower seeds, almonds, sunflower oil, hazelnuts, and peanut butter.

Other dietary antioxidants include beta-carotene (carrots, sweet potato, apricots, green vegetables) and selenium (Brazil nuts, tuna, shrimp, turkey).

Unlike supplements, whole foods provide vitamins and minerals along with fibre and hundreds of phyto-chemicals, which work together to protect health.

50 and above

Most older men cannot eat the way they did in their 20s and maintain a healthy weight. As men age, they typically become less active, lose muscle and gain fat. All of these things combined can cause metabolism to slow down. More physical activity is needed to keep metabolism up.

How many calories you need each day depends on your age, gender, and activity level.

Approximate daily calorie needs for men over of 50:

• 2,000 calories if not active.

• 2,200 to 2,400 calories if moderately active.

• 2,400 to 2,800 calories if regularly active.

Older adults need more vitamin D and calcium to help maintain strong and healthy bones. Calcium-rich foods include low-fat and fat-free dairy foods including milk and yogurt, fortified cereals, non-dairy milk and 100 per cent fruit juices, dark green leafy vegetables, and canned fish with soft bones.

Older adults need three servings of calcium-rich foods and beverages and sources of vitamin D every day. If you take a calcium supplement or multivitamin, be sure to choose one that contains vitamin D.

Fibre helps keep bowel functions normal and may influence digestive health by promoting the survival of good bacteria. Higher intakes of dietary fibre also have been shown to help decrease the risk of developing Type 2 diabetes and heart disease. Many fibre-rich foods take longer to chew and can help keep you full longer.

Men older than 50 need 30 grams of dietary fibre a day. Good sources are whole grains, fruits, vegetables, beans and lentils. Try to ensure at least half the amount of grains you consumer are whole grains. Oatmeal, brown rice and whole-wheat bread are all good sources. Also, aim to eat a variety of fruits and vegetables throughout your day. For products with a ‘Nutrition Facts’ label, such as cereals and bread, choose foods with at least 3 grams of dietary fibre per serving.

Most of the fats you consume should come from heart-healthy unsaturated fats. Try extra-virgin olive oil, canola oil, walnuts, almonds, and avocados. Saturated fat, which comes from meat and full-fat dairy should be limited to less than 10 per cent of total calories.

Source: Dr Janani Satchithanantham, senior dietitian, Aster Hospital, Al Qusais

SKIN

40 to 60

As men age, they tend to lose volume in the face due to the reabsorption of bone and fat. Men have a thicker skin but less subcutaneous tissue. Muscles are inherently stronger in men and so they are more prone to expression lines. Common concerns are quality of skin, pigmentation, hollowing around eyes, sagging jawline and neck.

An increasing number of men are opting for body contouring. But it is vital that they undergo a thorough medical investigation before the decide to do so. Men are more prone to visceral fat than women that makes them susceptible to medical conditions.

Tips to care for you skin

Pay greater attention to areas around your eyes and mouth as these areas age faster. Invest in a good eye cream/serum. Do not ignore your neck and hands and invest in a good hand cream.

By now the chances are that your face is really dry as you are losing the hyaluronic acid in your skin and skin regeneration is slower. Opt for a cream cleanser and continue to cleanse once or twice daily.Focus more on moisturising and regenerative products.

Source: Dr Mansi Suman Mukherjee, Head medical and service innovation and specialist dermatologist, Kaya ME

ENDOCRINOLOGY

40 and above

Erectile dysfunction (ED), or impotence can happen at any age, but is more common in men older than 65. The most common causes of ED are health problems that affect blood vessels and blood flow in the penis. These include the hardening of the arteries called atherosclerosis, which is linked to diabetes, obesity, smoking, high blood pressure, and high cholesterol. Therefore, ED may be a sign of heart disease or other serious health problems.

Gynecomastia is breast enlargement in men due to a benign (non-cancerous) increase in breast tissue. This condition results from an imbalance between the masculinising hormone testosterone and the feminising hormone oestrogen. Fat in the body normally converts the testosterone to oestrogen. In adults, it’s most common in men over the age of 50 years. It may affect only one or both breasts. Many factors cause enlarged breast tissue in men including the hormonal changes of ageing, increased body fat (which can increase oestrogen levels), over use of medicines.

The prostate gland is part of the male reproductive system, located in the abdomen below the bladder. Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland. As men age, it’s common for the prostate to get larger. As the prostate enlarges, it can squeeze the urethra (the tube for urine to pass out of the body), affecting the flow of urine. BPH does not lead to prostate cancer but it affects half the men in their 60s and most men in their 70s. Family history, ethnicity (less common in Asians), obesity, and sedentary lifestyle are risk factors

Although for most men many of the symptoms do not get worse for years, a rare complication of BPH involves a sudden and complete blockage of urination. This needs to be treated immediately.

For moderate to severe symptoms that interfere with daily life, there are a few types of drug treatments.

The main surgical treatment for BPH is a transurethral resection of the prostate or similar procedures to remove excessive prostate tissue blocking urine flow.

Surgery is an option if you:

• Are not able to completely empty your bladder (which can damage the kidneys)

• Are not able to urinate

• Are not able to hold your urine (incontinence)

• Have repeated infections that are difficult to treat (due to incomplete emptying of the bladder)

Prostate cancer is one of the most common types of cancer in men. While it grows slowly and is initially confined to the prostate gland, it may spread to the urinary tract and bladder. Risk factors include age, race, family history and obesity.

Screening is advised for men at the age of 50 even if there are no symptoms.

You can reduce your risk of prostate cancer if you:

• Choose a healthy diet that includes fruits and vegetables.

• Choose healthy foods over supplements.

• Exercise most days of the week.

• Maintain a healthy weight.

Source: Dr Ajith Kumar, specialist endocrinologist, Al Futtaim Healthcare

CARDIOLOGY

40 and above

Elderly men often have atypical symptoms of heart diseases. Unlike younger age patients, chest pain may not be the main presenting symptom. Giddiness, fatigue, sweating and breathing difficulty may also cause coronary artery disease.

Elderly men may develop degenerative disease of the heart valves, which often presents as breathing difficulty. Problems in heart beat are also common, causing giddiness and fainting. In case such symptoms persist, they need to consult a doctor to check for pacemaker therapy. If they have fast irregular beats (atrial fibrillation), they need hospitalisation and treatment.

Source: Dr Sundar Kumar, consultant interventional cardiologist, Prime Hospital, Dubai

MENTAL HEALTH

40 to 50

Early 40s may be the beginning of male menopause (also called andropause) sexual health problems, alopecia, stress and depression.

Andropause causes a decrease in testosterone levels, which can affect physical, sexual, and psychological problems which typically worsen as men get older. Combined with other common responsibilities in life – such as work pressures and managing relationships – many can struggle to cope.

The symptoms are easy to spot and include low energy, decreased motivation, difficulty concentrating, increased insomnia, increased body fat, erectile dysfunction, reduced libido and a decrease in self-confidence.

To prevent conditions from spiraling out of control:

• Exercise regularly

• Enjoy a healthy and balanced nutritious diet. Recently research has revealed that a Mediterranean diet which is rich in vegetables, fruit, nuts, fish, lean meat and olive oil, can improve the mental health of adults living with depression and be a more effective treatment than social support.

• Participate in activities that help to de-stress e.g. mindfulness, walking, swimming and cycling. Getting out in the fresh air can work wonders.

• Improve sleep hygiene. Regular sleep and waking patterns are key. Turn your bedroom into a sanctuary free from electronic devices and work-related paraphernalia, and avoid stimulants such as cigarettes and caffeine at least six hours prior to bedtime.

50 and above

The mental health issues in this age group are dramatically different from their predecessors. Most individuals may be extremely reflective and question what their value and purpose has been in life.

Men in this age group also have to come to terms with loss in its many forms. Loss can be experienced because many men in this age range are coming to the end of their career and are looking ahead to retirement. In addition, they may well be experiencing the loss of loved ones, leading to feelings of immense grief.

Grief is described in five main stages; shock/denial, anger, bargaining, depression and acceptance.

To effectively manage their mental health and keep on a positive track, men have to develop support network. As humans we are social animals and need people who we can trust and talk to. Undertaking activities that are in line with one’s values can help individuals feel more connected to what is important to them.

Source: Mandeep Jassal, therapist, Priory Wellbeing Centre, Dubai