Stephen J. Schueler, M.D.

Overview Conditions Evaluation guideline age 19 - 39 guideline age 40 - 49 guideline age 50 - 59 guideline age 60 - 69 guideline age 70+ Prevention diet counting calories exercise fitness check fitness program taking control

Men's Health Prevention

General guidelines for disease prevention in men include:

Men's Health Diet

Strategies for a healthy diet in men include:

  • Limit your intake of fat to 30% of your total calories.
  • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil.
  • Consume only unsaturated fats that are low in cholesterol.
  • Consume less than 300 milligrams of cholesterol a day.
  • Eat dietary fiber: whole grains are best.
  • Avoid fad diets.
  • Check with your doctor about B vitamin supplements. Some people may benefit from B vitamins.
  • Talk to your doctor about vitamin D supplements.
  • Eat foods that are rich in omega-3 fatty acids:
    • Omega-3's are present in salmon, tuna, and mackerel.
    • Walnuts and flax seed are also rich in omega3's.
    • If you don't like fish, your local pharmacy has omega-3 supplements in capsule form.

Key Dietary Recommendations for Chronic Disease Prevention
Energy (calories)to maintain BMI < 25
Total fats< or = to 30% of total daily calories
Saturated fats< 7% of total daily calories
Polyunsaturated fats< 10% of total daily calories
Monounsaturated fats< 13% of total daily calories
Cholesterol< or = to 300 mg per day
Dietary fiber25-30 grams per day
Fiber type3:1 insoluble to soluble fiber
Sodium< or = to 1,500 mg per day
Calcium 9-24 yrs1,200-1,500 mg per day
Calcium 25-50 yrs1,000 mg per day
Calcium 51-65 yrs1,200 mg per day
Calcium >65 yrs1,500 mg per day
Vitamin D 9-50 yrs200 IU per day
Vitamin D 51-70 yrs400 IU per day
Vitamin D >70 yrs600 IU per day
Folic acid400 micrograms (ug) per day
Fruits & vegetables5-7 servings per day
Alcohol (men)< or = to 2 drinks per day

Men's Health Counting Calories

Obesity is a major risk factor for poor health in men. In order to avoid overeating, it's important to understand how the body maintains energy balance: regulating energy intake so that it equals energy output.

Consider the following equation:

Energy In (food intake) = Energy Out

When energy intake exceeds energy output, weight gain occurs. When energy output exceeds energy intake, weight loss occurs. Any imbalance in this equation will have direct results on body weight. For instance, the individual who eats regularly, but receives little or no exercise will usually gain weight. The cancer patient with a decreased appetite and a rapidly growing cancer tends to lose weight. This individual is simply unable to keep up with the energy demands the cancer is placing on the body.

Food is essential because the body needs it to function properly. However, eating more food than the body needs leads to the storage of excess body fat. Exercise requires calories and helps consume body fat. These components must be balanced to achieve body weight goals.

The number of calories people need depends on their weight, age, and level of activity. The calculation of total caloric intake necessary to simply maintain a certain body weight is as follows:

Desired Weight (in pounds) multiplied by a level of activity value will equal the number of calories you need each day to maintain your weight.

Desired Weight x (level of activity value) = total calories needed per day

The level of activity value is determined as follows:

10Light physical activity
15Medium physical activity
20Heavy level of physical activity

The total calories needed per day should be adjusted based on your age group. Use the chart provided below:
25-34subtracts 0 from your total calories
35-44subtracts 100 from your total calories
45-54subtracts 200 from your total calories
55-64subtracts 300 from your total calories
65 +subtracts 400 from your total calories

The result obtained after this step should be a closer estimate of the total calories needed per day to maintain a desired weight, based on a commitment to a particular level of activity.

Once total calories are known, it is important to calculate the calories from each food group. Using the example above for a person who is going to consume 1,500 total calories per day:

1,500 total calories per day x 0.30 (30%) fat calories = 450 calories

This shows that 450 calories of the total 1,500 daily calories may be from fat sources. We also know that each gram of fat provides 9 calories, so that the person in our example can eat about 50 grams of fat per day (450 calories divided by 9 calories/gram of fat) and still be following these guidelines.

The same calculations can be performed for protein and carbohydrates. There are also many tables and simple computer calculators that will perform these tasks quickly and accurately.

Men's Health Exercise

Here are some important questions regarding men's health and exercise.

What is exercise?
Exercise is physical work that keeps the body healthy. Regular exercise has been found to prolong your life. Many people perform hard physical labor, but are not "physically fit".

What is fitness?
Fitness is a sense of well being. You feel energetic, relaxed, and strong when you are physically fit. Your body is usually trim, flexible, and coordinated. Regular exercise is an important part of physical fitness. A healthy diet and lowering stress also help you to be physically fit. Exercise can also reduce stress that allows you to be more "mentally fit".

Exercise affects your body in very complicated ways. Scientists have found that exercise is good for your body in many respects. It may help prevent and treat some illnesses, such as:

More people die from heart disease than any other illness in the United States. Doctors have found that the risk of heart disease is much lower with regular exercise. This is why exercise has become very important in the treatment of heart disease.

How will exercise make me feel?
You must perform regular exercise in order to become physically fit. As you exercise, your body adapts to (becomes used to) the work it must perform. You are then able to tolerate more strenuous activity without tiring. When it becomes a habit, you will feel stronger and more relaxed during normal activities. You will probably sleep better. The exercise may even allow you to lose weight if you follow a proper diet.

Will exercise always help treat illnesses?
Exercise may make you feel better overall, but it will not always make an illness better. For example, let us say you have emphysema (COPD) or lung disease from smoking. Regular exercise may help increase your ability to do things without tiring. You may have much more energy and strength. However, the disease does not improve, and you may not slow down the worsening of the disease.

Physical fitness is a state of mind. You will probably live a healthier lifestyle if you are motivated to be "fit". You may follow a healthy diet, lose weight, stop smoking, and reduce your use of alcohol. All of these factors make you feel better, and allow your body to tolerate an illness better. Exercise also helps your body fight infections.

What are the benefits of exercise?
There are tremendous benefits to regular exercise. Exercise can:

How does exercise help certain diseases?
For all of the following diseases, your doctor should help you plan an exercise program. Exercise has the listed effects on the following illnesses:

In summary, diseases are not caused by a lack of exercise. But physical fitness will improve general health and help slow aging. Talk to your doctor about an exercise program that is right for you. Most importantly, choose an activity that you enjoy!

Men's Health Fitness Check

Cardiovascular Fitness Evaluation for Men
The 3-minute step test can provide important information concerning the exercise capacity of your heart and your cardiovascular fitness level. Your pulse rate during exercise is a useful guide to how much work your heart is doing. With this information you can make sure you are exercising with enough intensity to guarantee a good conditioning effect, while not pushing yourself too hard.

Before starting this test you must first answer all of the following questions:

Note: If the answer to any of the above questions is "yes", then check with your doctor before attempting the step test!

General Principles
Stop exercising immediately if you develop extreme shortness of breath, chest pain, lightheadedness, or dizziness. You can determine your pulse rate during exercise by stopping and then measuring your pulse rate for 10 seconds. Multiply this number by 6 to obtain the number of beats per minute. To perform a complete assessment of your cardiovascular fitness, you must perform the step test for a full three minutes using the technique as described below.

How to perform the 3-minute step test:
  • Find something sturdy to use as a 12-inch high step. A small bench or a securely tied stack of newspapers or magazines can be used. Do not use a stairway.
  • Facing the step, first step up with one foot, and then the other. Next, step down with one foot, then the other. Each sequence of getting up and down from the bench (with both feet) counts as one step.
  • The pace is critical.... you must make 24 full steps each minute---that's 2 every 5 seconds for a full 3 minutes!
  • After the 3 minutes has elapsed, sit down and take your pulse approximately 5 seconds after completing the step test. Compare results with the standardized charts below.

Resting Heart Rate: determine your heart rate by measuring your pulse when you first awaken or after you have been resting for at least
10 minutes.

Normal Resting Heart Rates
Age RangeAverage Beats Per Min
1 month120-130
6 months120-130
1-2 years110-120
2-3 years100-110
4-5 years95-105
6-8 years90-100
10-12 years85-95
14 years75-85

Exercise Heart Rate
Measure your pulse rate during exercise to determine how much work your heart is doing (what level of intensity you are exercising at).

Target Heart Rate Levels
Exercise Intensity LevelTarget Heart Rate
Low Intensity50 to 60% max beats per min
Weight Loss Intensity50 to 70% max beats per min
Average Intensity60 to 70% max beats per min
High Intensity70 to 80% max beats per min

Target Heart Rate Age Chart
AgeExercise Intensity Level
Low Weight LossAverageHigh

Note: If you are taking high blood pressure or heart medications that affect your pulse rate, check with your physician to determine the appropriate target heart rate for you.

During exercise your heart should be working hard enough to assure a good training effect, but not so hard as to be unsafe. During exercise you should attempt to keep your heart rate inside the ranges depicted on the target heart rate for exercise chart shown above. These values do not apply to those who are taking beta-blockers, which slow the heart rate, or those who have an artificial pacemaker.

Interpreting Pulse Rate Results of 3 Minute Step Test for Males
Excellent< 75< 78< 80< 85< 90

For women see:

Be sure to discuss all results and any symptoms that may arise with your physician.

Men's Health Fitness Program

Here are some important questions regarding men's health and setting up an exercise program.

How do you start an exercise program?
Unfortunately, few Americans get regular exercise. You are more likely to adopt a regular exercise program if you choose activities that you enjoy.

An exercise program for both men and women should include:

  • Exercise 3 times a week.
  • Exercise for 20 minutes each time.
  • Increase your heart rate (pulse) when exercising. See target heart rate information below.

You should see your doctor before starting an exercise program if:

If you are over 65, you need to focus on balance and strength exercises first. Then, you may perform "aerobic" exercises regularly such as walking, biking or swimming.

What makes up an exercise program?
  • Type: there are a few major types of exercise:
    • Aerobic: constant exercise for a prolonged time (walking, biking, swimming)
    • Stretching: makes you more flexible
    • Weight lifting: increases muscle tone and strength
  • Intensity: how difficult (strenuous) the exercise is:
    • Usually followed by your pulse (heart rate) during the exercise
    • Your doctor should recommend a pulse that is right for you
  • Duration: how long the exercise lasts:
    • 25-45 minutes for each session
  • Sessions: what you do during the exercise time:
    • 3-5 minutes for warm-up
    • 15-40 minutes for aerobics or weight training
    • 2-5 minutes for cool-down
  • Frequency: how often you exercise:
    • Daily if you exercise less than 30 minutes or your intensity is low
    • Every other day if you exercise greater than 30 minutes or your intensity is high
  • Progression: how you increase your exercise difficulty or time
    • Start out slowly
    • Keep your pulse in the target range
    • Use a logbook to keep track of progress

What are some moderate vs high intensity activities?
Moderate Intensity ActivitiesHigh Intensity Activities
Walking briskly (3 to 4 mph)Aerobics
Toning exercisesTai-bo
Mowing lawnCycling (racing)
Golf (pulling or carrying clubs)Climbing hills
Home repairCross country skiing
Fishing, standing/castingFitness walking
Jogging (medium pace)Swimming
Swimming (medium pace)Roller skating
Cycling (< 10 mph)Tennis
Canoeing (2-4 mph)Soccer
House paintingJumping rope
CarpentryJogging or running

What are calories?
Food supplies our bodies with energy. Calories are the units we use to measure the energy that food contains. Some types of exercise tend to burn more "calories". Also, you have to exercise harder or longer to burn more calories.

How many calories are burned by certain activities?
ActivityNumber of Calories Burned
Walking (brisk)100 calories burned per mile
Jogging120 calories burned per mile
Swimming100 calories burned in 20 minutes
Bicycling (easy pace)100 calories burned in 20 minutes
Aerobic exercise to music100 calories burned in 20 minutes
Gardening (vigorous)100 calories burned in 30 minutes

Pulse Rate During Exercise
Your resting pulse is a simple and accurate estimate of your cardiovascular fitness. As your activity level increases your pulse increases to compensate(unless you take medication that blocks this response by your pulse). As your cardiovascular condition improves (through exercise) your resting heart rate will decrease. This is related to increased efficiency in the function of the heart and vasculature. The speed at which your heart rate drops back down to resting levels after exercise is also an indicator of cardiovascular fitness. The quicker your heart rate returns to resting levels, the more fit you are.

Maximum Heart Rate (MHR)
Your MHR is defined as your age subtracted from 220. For example, a 30 year-old has a MHR of 190 beats per minute. In your exercise program, the MHR is a limit you should try not to meet or exceed.

Target Heart Rate (THR)
When you train, your heart rate should be between 50 and 80% of your maximum heart rate. This is known as your target heart rate (THR). Studies show that exceeding 80% of your MHR provides no additional benefits and may be counterproductive. Those who are poorly conditioned, or beginning a new program, should stay closer to 50% of their MHR until they begin to see results. In general, training at the higher end of your training zone (70-80%) will improve your aerobic fitness. Training at the lower end (60-70%) for a longer period will allow your body to burn more fat (weight loss).

Target Heart Rate Levels
Exercise Intensity LevelTarget Heart Rate
Low Intensity50 to 60% MHR
Weight Loss Intensity50 to 70% MHR
Average Intensity60 to 70% MHR
High Intensity70 to 80% MHR

Target Heart Rate Age Chart
AgeExercise Intensity Level
LowWeight lossAverageHigh

If you are taking high blood pressure or heart medications, which affect your pulse rate, check with your physician to determine the appropriate target heart rate for you.

What are some tips on how to exercise?
  • Always use a mat under you when doing floor exercises.
  • Always wear the right shoes for each activity. They must fit well. If they are too loose, you may suffer blisters. If they are too tight, you may injure your feet. Your socks should pad the skin and absorb sweat well.
  • Avoid exercising outdoors in very warm or very cold weather.
  • Avoid exercising right after you eat. Wait at least two hours after eating before heavy exercise.
  • Do not wear loose jewelry.
  • Drink plenty of fluids before and after exercising.
  • Keep a sugared drink nearby:
    • A low-fat, sugared snack may be helpful if you exercise for more than 45 minutes.
    • This is very important in the diabetic who may feel that their blood sugar is low.
  • Exercise in a room with good air circulation. The room should be slightly cool at the start. Then you will be more comfortable when your body heats up.
  • Exercise only when feeling well.
  • Exercise with a friend.
  • Find an exercise routine, teacher, and program that you like.
  • Music may help you enjoy your workout. However, be sure that you can hear cars if you are near the road.
  • Set realistic and safe goals for yourself.
  • Take your pulse at the wrist. Do not take your pulse at the neck. Pressure on the carotid artery in the neck may make you faint.
  • Try to exercise at the same time each day so it becomes routine.
  • Wear loose, layered clothing. As you warm up, you can take off the layers.
  • Performing strenuous exercise while wearing "sweats" can be dangerous. Your body naturally tries to cool itself by sweating. Wear only enough clothing so that you are warm during the exercise.

When should you stop exercising?
You should stop exercising if you do not feel well or have any of the following:

Men's Health Taking Control

Maintaining good health requires your participation. Here are answers to some important questions about men's health.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared. Think about what has made your problem better or worse.
  • Most doctors ask many questions about "unrelated" symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

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