2nd November 2017 The MALESTROM

The doctor will see you now – Dr Sara Kayat talks men’s health

With the ever growing pressures of modern day living it’s no wonder the nation’s health is suffering. With the constant stress of work and the pressure to pay those ever increasing bills weighing heavily on our collective shoulders it’s not a big surprise that many of us find it hard to take some time out and make sure that our all round physical health is in tip top condition. Indeed men in general are notoriously bad when it comes to heading to the doctors and getting a once over, that being the case we’ve brought one to you. We spoke to Dr Sara Kayat to get some answers to the most pressing health questions affecting men of all ages.

How dangerous a condition is stress? And what would you recommend for people suffering from it?

Dr Sara Kayat: Whilst evolutionarily, the purpose of stress was related to triggering the fight or flight response when confronted with a survival situation, in modern day life, there is little benefit in feeding stress. We have long been aware of the role that stress plays in exacerbating anxiety and depression, but more recently research has also focussed on its effects on physical health. Studies have uncovered a link between stress and cardiovascular disease and have suggested that it may be as important a risk factor as smoking and high blood pressure.

Stress can be multifactorial but a good first step in managing it, is to identify your triggers. Unsurprisingly given that we work the longest hours in Europe, work is one of the biggest contributors to stress in the UK. As such, maintaining a good work-life balance is paramount, and keeping an open dialogue with colleagues and managers about mental health and stress is important in maintaining wellbeing in the workplace, as well as making sure you carve out time to do things you enjoy, and see people that make you happy. We know that cardiovascular exercise is also important in tackling stress, by increasing you’re your dopamine and serotonin levels, but other forms of exercise like yoga is also beneficial in promoting relaxation techniques like meditation, breathing and mindfulness, all of which have been shown to help manage stress.

Other lifestyle measures that may help your stress levels include reducing your alcohol intake, ensuring you are getting enough sleep and having a well-balanced diet. More research is going into how diet may affect stress levels, and the concept of a “brain-gut axis” is becoming more widely accepted.

Certainly, if these measures aren’t helping your stress, it is important to speak to your doctor, as you may benefit from talking therapies and other psychological input.

How important is getting enough sleep to living a healthy life?

DSK: Sleep is considered one of the pillars of health, alongside nutrition and exercise. We have all felt the effects of a sleepless night, but its effects may go deeper than just the suboptimal performance and productivity the following day. Insomnia and sleep deficiency has been linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, stroke and obesity.

Would you say the majority of health issues in the Western world come down to diet?

DSK: Globally, poor diet is a factor in one in five deaths and is considered the second highest risk factor for an early death after smoking. The ‘Western Diet’ which is low in fruits and vegetables, high in saturated and trans fats, processed meat, sugar, and salt, may be cheap and tasty, but is contributing to the obesity epidemic, and leading to the development of high blood pressure, heart disease and strokes. The Western diet has also been linked to an increased risk of Alzheimer’s disease.

Many people are cutting down or cutting out red meat from their diets these days. Would this be something you would advocate?

DSK: The consumption of red meat is fairly controversial. On the one hand, we know it contains high amounts of protein, vitamin B12, zinc and iron which are all needed by the body to maintain healthy nerves, muscles, immune system and red blood cells. But the Department of Health recommends that adults eat no more than 70g a day as there is a link between high red meat consumption and bowel cancer. Other observational studies have also linked red meat to diabetes and cardiovascular disease. In general, I recommend “everything in moderation” but it is safe to remove or cut down red meat from your diet as long as you are replacing the nutrients from other sources- there are plenty of substitute meats and vegetables that can fill the void of red meat, such as chicken, eggs, nuts, and beans.

Two day fasting is becoming a bit of a fad at the moment. What are your thoughts on this?

DSK: When we starve ourselves, our body, which normally uses glucose from our diet for energy, must turn to our fat stores, which consequently leads to weight loss. This process is replicated in fad diets, like the 5:2 diet, which is a form of intermittent fasting. Some advocates of intermittent fasting have suggested that in addition to weight loss, the process can improve brain function and protect against conditions like dementia.

Whilst evidence for this is still limited, there have been some studies showing weight loss (comparable to calorie restricted diets) leading to an accompanying reduction in the risk of developing chronic diseases like Type 2 Diabetes. One fasting study was even linked to a reduction in the risk of certain obesity-related cancers like breast cancer. I think these are very encouraging results, but as with all fad diets my main concern is with regards to the longevity.The 5:2 diet is challenging and a lot of will power is required to maintain it.

Dr Sara Kayat

What are your concerns about people using the internet to self diagnose? And can it ever be reliable?

DSK: I actively encourage my patients to take their health into their own hands when possible and I love how the internet has empowered people to understand their body and the processes that may be occurring. But there is a lot of information (and misinformation) out there, and I often find my patients lost in this sea of data, overwhelmed by the conflicting advice.

Thousands of medical sites, blogs, and Wiki pages can spew out confusing, overwhelming, unreliable or panic-inducing information. In an age where anxiety is on the rise, this uncertainty in diagnosis and medical management is only adding to the concept of health anxiety. Psychologists have given this tech-enabled obsessing over real symptoms or imagined ills a name: ‘cyberchondria’. Whilst there are many things that can be self-managed, it’s so important when there is any doubt to seek medical advice from a qualified doctor or GP, who can give a professional diagnosis and the most effective treatment.

Men are notoriously bad at getting checked over, what would you say to blokes that avoid the doctors?

DSK: It is well known that men visit the GP less than women, which is why there are a number of major awareness campaigns focused on men’s health, to encourage men to engage in managing their own health, and to understand what is normal, and more importantly what is abnormal. Listen to the public health campaigns and don’t ignore those health-check invites to the GP, prevention is better than cure.

Is there an age where people should start being checked over more?

DSK: Health is not affected by age alone; your risk factors for health problems may be based on several things including your gender, past medical history, family medical history etc. Therefore, there is no specific age at which I would say you need to be checked over more, but on the NHS you are offered a “health check” when you reach 40, and depending on the outcome of that health check your doctor may recommend medications and lifestyle changes, and will advise you when you need to next be reviewed. However, if you develop any new symptoms that you are concerned about, it is important to see your GP sooner.

Are there any common health signs that men should look for?

DSK: Heart disease is the leading killer of both men and women, but almost twice as many males die of conditions that affect the cardiovascular system. As such it is important to look out for signs that your heart is struggling. Take note of any persistent headaches that may indicate that you have high blood pressure, be aware of whether you are becoming more short of breath on exertion, or more aware of your heart beat and certainly seek medical help if you are having any chest pains.

Be aware of the symptoms of an enlarged prostate. If you are developing any change to your urinary stream, or the feeling of not completely emptying your bladder, needing to pass urine more frequently or with more urgency- you may need a rectal exam to check for an abnormal prostate and your doctor may offer you a prostate specific antigen (PSA) blood test to screen for prostate cancer.

Impotence in men can be a sign of an underlying health condition and shouldn’t be ignored. Half of all men over the age of 40 have suffered with erectile dysfunction at some point, and whilst it may simply have a psycho-sexual cause, it is important to rule out physical conditions like high blood pressure, diabetes or heart disease as a cause.

What kind of self-checks other than their testicles should men be doing?

DSK: Aside from testicle examinations, men should also do these top three self-checks:

Belly fat check:

Measuring the fat around your belly is one of the most important self-examinations for most men. More than other fat, belly fat produces hormones that increase men’s risk for heart disease and diabetes. To do this self-check, simply wrap a tape measure around your waist at the level of your belly button. If you measure more than 37 inches, you’re at risk for potentially serious health problems. Repeat this exam about once a month.

Heart rate check:

One quick self-exam to gauge the health of your heart is to check your pulse when you’re at rest. Place the first two fingers of one hand on the area at the base of the wrist on your other hand. Count your pulse for 10 seconds and multiply by six. A normal pulse (heart rate) for a man should be between 60 and 100. Anything outside that range could be a sign of cardiovascular problems. You should also pay attention to the space between beats. An irregular pulse could be a sign of atrial fibrillation or other serious heart issues. Repeat this self-exam at least once every month.

Oral health check:

Oral cancer and gum disease are important men’s health issues. Oral cancer may show up as a sore or lump that doesn’t heal on the lips or in the mouth. To check for potential tumours, open wide and look and feel for any abnormalities, running a finger around and under your tongue. White or red patches in your mouth can be early warning signs of oral cancer. Always let your doctor or dentist know about these findings. Repeat this check monthly.

 

Dr Sara is one of the founding GPs of GPDQ. GPDQ (GP Delivered Quick) is the UK’s first doctor-on-demand app, which delivers a doctor to your door within hours of making a booking via the app, website, or over the phone. The service enables its users to book a GP visit at their home, work or a hotel if they are travelling from abroad. Once booked, they can track their GP in the app and receive live updates on their ETA. GPDQ is available on iOS and Android, in Greater London, Birmingham, and Manchester, with other UK locations coming soon.

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