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Take action and reduce your health risks Aetna Health ConnectionsSM Wellness Resources Men’s health and wellness. Know your body and take control of your health. 21.05.312.1 (8/06) Men’s Health & Wellness Booklet In this booklet, find out about common health problems that affect men and how you can reduce your risks. Be prepared to live a healthy life Diseases that are common in men have risk factors that both can and cannot be changed. The more you know, and the positive actions you choose to take, will give you better control over your health and well being. Living a healthy life takes time, energy and most important, your attention. You can take control of your health by knowing your body and how it changes from year to year. The key to treating health problems is finding out about them early enough so you can take action and get the right care. Whether it’s a visit to your doctor, a health screening or test, or following through on a suggested procedure, it is up to you to seek the right treatment. In this booklet, you will find: ■ Easy-to-understand health definitions ■ Common health problems that affect men ■ How you can reduce your risks ■ Tips for eating right and exercising ■ Things to talk to your doctor about Risk factors you can’t control Family history Race/ethnicity Family history can have an affect on your chances of getting certain health conditions or diseases. Things that can make your chances of health problems higher include:1 While you can’t control where your family comes from, this information is tied to many diseases and health conditions, such as: ■ ■ ■ Diseases that show up 10 to 20 years earlier than they usually do The same disease in more than one family member Diseases that do not normally occur in a certain gender (such as breast cancer in men) Certain combinations of illnesses in a family It is important to know your family history and share it with your doctor. You should focus on the following: ■ ■ Major health problems and the age of the family member when it started ■ Reasons family members died ■ Ethnic background ■ Diabetes – Native Americans are most likely to get diabetes (15.1 percent) followed by non-Hispanic Blacks (13.3 percent), Latinos (9.5 percent) and non-Hispanic Whites (8.7 percent).2 Cardiovascular disease – The chances of getting heart disease is higher among African Americans, Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is because they have higher rates of obesity and diabetes.3 Cancer – Prostate cancer is more common among some ethnic groups. African American men are 61 percent more likely to get prostate cancer and nearly 2.5 times as likely to die from it than Caucasian men.4 The reasons why are unknown, but white men have a higher chance of getting testicular cancer than African Americans. Alaska natives are the most likely to get colorectal cancer, while Hispanics and Filipinos are the least likely. Whites and African Americans fall somewhere in between. Talk to your doctor about how your race and ethnicity may affect your health today and in the future. For more information on risk factors you can’t control visit Aetna InteliHealth® at www.intelihealth.com to learn more about health risk factors. Did you know? ■ ■ Your family history cannot be changed. But you can take greater control of your health when you are aware of risk factors that have family ties. If you are at greater risk because of family history, you should be aware of and take action on the risk factors you can control. These include blood pressure and cholesterol levels; obesity; smoking; diet and exercise; psychological stress, anger and depression; and how much alcohol you drink. 1 Age As your body ages, it changes – this is natural. However, if you feel or notice anything that is not normal, talk to your doctor about it. Getting older can put you at risk for: ■ ■ ■ ■ 2 Diabetes – Older men are more likely to get diabetes. For example, 9.6 percent of all people age 20 years or older have diabetes, while 20.9 percent of all people age 60 years or older have diabetes.5 Cardiovascular disease – More than 83 percent of people who die of heart disease are 65 years old or older.6 You can have a stroke at any age but your chances are higher the older you get. Cancer – One out of every six men gets prostate cancer. It is the most common cancer other than skin cancer. More than 65 percent of people who get prostate cancer are older than age 65.4 The older you get, the greater the chances that you can also get colorectal cancer. Men between the ages of 15 and 34 years old have a higher chance of getting cancer of the testicles. Degenerative joint disease (Osteoarthritis) – As you get older, the cartilage in your joints can break. The bones can rub against each other, causing pain and making it hard to move the joint. This is called osteoarthritis. If you feel pain in your joints, talk to your doctor, who may suggest getting an X-ray or MRI to find the problem. Risk factors you can control Blood pressure CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS Blood Pressure Classification SBP mm/Hg DBP mm/Hg Normal < 120 and < 80 Prehypertension 120 – 139 or 80 – 89 Stage 1 Hypertension 140 – 159 or 90 – 99 Stage 2 Hypertension > 160 or > 100 SBP: Systolic Blood Pressure DBP: Diastolic Blood Pressure Keeping your blood pressure in the normal range can reduce your chances of stroke, heart attack, kidney failure and congestive heart failure, by reducing the amount of work your heart does. It can also help your heart and arteries from getting hard. Adults should have their blood pressure checked every few years. If it is higher than 120/80 mm/Hg, make regular appointments with your doctor to have it checked.3 Cholesterol Cholesterol is an important part of your body. But too much of it can clog your arteries or make your arteries narrow and hard. This can slow down or even stop your blood from traveling through your body (called atherosclerosis). Your doctor will tell you to keep your total cholesterol level below 200 milligrams per deciliter. Too much cholesterol in your blood (240 mg/dL or higher) puts you at risk for diabetes, heart disease and stroke. High levels of Low Density Lipoprotein (LDL or “bad” cholesterol) greater than 100 mg/dL, and triglycerides (blood fats) of 150 mg/dL or higher raises your risk for these problems. So do low levels (less than 40 mg/dL of High Density Lipoprotein (HDL, or “good” cholesterol).7 To stay healthy, lower your LDL levels and eat foods that increase your “good” cholesterol levels (HDL). Smoking If you smoke, it’s important to do everything you can to stop. Smokers have a greater risk for asthma, Chronic Obstructive Pulmonary Disease, and cancers of the mouth and lungs. Talk to your doctor about programs that can help you quit smoking. Some states have free “Quit Lines” with trained counselors. To find educational materials on how to stop smoking, visit www.aetna.com. From the home page, select Members: Public Information, Health and Wellness, Living Well, Self Management, and then Freedom from Smoking. Obesity People who are too heavy for their height are considered to be obese. Obesity occurs when a person eats too many calories and does not use them. It is directly linked to a higher chance of health problems and some diseases. 3 Obesity Obesity in this country has grown significantly in the past 20 years. Doctors now think that more than 60 million people are obese. That is 30 percent of all the people in the United States.8 Your doctor will use the body mass index (BMI) to determine the right weight for your height.9 To find your BMI, look for your height in the left column of the chart below. Go straight across from left to right until you find your weight in pounds. The number in the top row of the chart is your BMI. What you should weigh is listed in the healthy range for your height. If you find that you are too heavy, talk to your doctor about changing what you eat and starting an exercise program. It could save your life. BMI 19 20 Height 21 22 23 24 25 Healthy Weight 26 27 28 29 30 Overweight 31 32 33 34 35 Obesity Class I 36 37 38 39 40 Obesity Class II 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191 59" 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198 60" 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204 61" 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211 62" 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218 63" 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225 64" 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232 65" 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240 66" 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247 67" 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255 68" 125 131 138 144 151 158 164 171 177 184 190 197 204 210 216 223 230 236 243 249 256 262 69" 128 135 142 149 155 162 169 176 182 189 196 203 210 216 223 230 236 243 250 257 263 270 70" 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278 71" 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286 72" 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294 73" 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302 74" 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311 75" 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319 76" 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295 304 312 320 328 4 Weight (Pounds) 58" Diet and exercise Alcohol abuse As you get older, it is important to watch what you eat. Eating food that is high in fat and cholesterol can raise your chances of getting diabetes, heart disease, obesity and some cancers. Your chances become even higher if you don’t exercise. Drinking too much alcohol can raise your blood pressure and harm your liver, brain and heart. Alcohol also has extra calories that can make it harder for you to lose weight. Limit what you drink to no more than two alcoholic drinks a day.10 Exercising for just 30 minutes a day can lower your risk of getting diseases like diabetes. It can also help you avoid heart and blood vessel disease by controlling blood cholesterol, lowering blood pressure and fighting obesity. You should always talk to your doctor before starting an exercise program. One alcoholic drink is: ■ 12 ounces of beer ■ 5 ounces of wine ■ 1 ounce of 80-proof alcohol If you have a drinking problem, it is important to get help. Here are some warning signs to be aware of: ■ ■ ■ Psychological stress, anger and depression You can control your chances of getting heart disease and stroke by controlling your moods and stress levels. If you think you are sad or depressed, talk to your doctor right away. Researchers have found proof that mental stress can have an affect on the blood vessels’ ability to expand. If your blood vessels can’t expand, your chances for having a heart attack or stroke can grow. ■ ■ Tolerance – The need to drink more to get the same effects. Withdrawal – Signs from mild hangovers, sickness and headache to really bad shaking. It usually starts soon after you stop drinking and can last a few days. Loss of control – This is when you can’t control your behavior when you’re drinking. You may also find that you are always thinking about drinking. Concern from others – Your friends tell you that you have a problem. Health, family and legal problems – You get injured often. You get many driving tickets. You’re always late and often fight with family members. If you think you may have a problem with alcohol, talk to your doctor about getting the right treatment. You can also visit Aetna InteliHealth® at www.intelihealth.com. Click on Addiction from the Diseases and Conditions menu to find out more about binge drinking and alcohol abuse. 5 Take control yourself with screenings and prevention Pay attention to a pulsating mass in the abdomen An abdominal aortic aneurysm is a dangerous swelling of part of the aorta (the body’s largest artery). This mass, which can lead to death, is commonly found in people age 60 and older. About 20 percent of people have a close relative with the same condition. Call your doctor immediately if you notice a throbbing bump in your stomach. If you have stomach or back pain, or pain in your side associated with a throbbing bump, get to a hospital right away. 6 By knowing your risks, you are taking the first step toward preventing health problems and disease. Your health care plan, which you can create with your doctor, should include a variety of screenings and prevention ideas, including eating right, exercising and keeping your doctor informed. Examine your skin Fifteen minutes a day of sunshine can help your body make vitamin D. Too much sun, however, can lead to problems ranging from dry skin to cancer. If Americans don’t take better care of their skin, half of all the people in this country who live to age 65 will get at least one skin cancer.11 You should regularly check the skin on your whole body, including your scalp, hands and feet. Talk to your doctor or dermatologist (skin doctor) right away if you have a sore that will not heal, or if you find redness around a freckle or mole. Recognize diabetes signs & symptoms Diabetes is a long-term sickness. It has serious risk factors and complications. To protect yourself, it is important to know the signs of diabetes. They include: ■ Often thirsty or hungry ■ Often tired ■ Going to the bathroom often ■ Unexpected weight loss or gain ■ Sores that heal slowly ■ Tingling in your feet ■ Blurry eyesight Talk to your doctor if you are 30 years old (or older) and have any of the signs above. Controlling your blood glucose (sugar) is important to stop additional health problems such as heart disease and stroke. Get annual cancer screenings You should make health screenings part of your yearly physical exam. By having your body tested regularly, you can get a handle on health issues that may need additional medical attention. More than 234,000 men in the United States will find out they have prostate cancer this year.12 Prostate cancer screenings Prostate cancer treatments can be more successful if the cancer is found early. Be aware of these signs and symptoms, particularly as you get older: ■ Weak urine stream ■ Urinating more than usual ■ Urge to urinate really badly ■ Suddenly can’t urinate ■ Getting many urinary tract infections ■ Seeing blood in your urine or semen If you have any of these symptoms or you are age 50 or older, your doctor may recommend two tests: ■ ■ Prostate-Specific Antigen Blood Test (PSA) – PSA is a protein produced by the prostate gland. It is released in small amounts into the blood. When the prostate is not working correctly, more PSA is released. Levels under 4 ng/mL are “normal,” results over 10 ng/mL are “high,” and results between 4 and 10 ng/mL are “intermediate.” Digital Rectal Exam (DRE) – During a DRE, the doctor checks the prostate gland by putting a finger into the rectum and feeling the gland to see if there is anything unusual. 7 Colorectal cancer causes the second highest number of cancer deaths in this country. It is expected to be the cause of about 55,000 deaths in 2006.13 Colorectal cancer screenings Early colorectal cancer has few signs. Signs of the advancement of the disease may include: ■ A change in bowel habits ■ Loose stools or constipation ■ Blood in the stool (bright red, black or very dark) ■ Narrowed stools (about the thickness of a pencil) ■ Bloating, fullness or stomach cramps ■ Gas pains ■ Feeling that your bowel is not empty ■ Weight loss without dieting ■ Always tired If you are over age 50, talk to your doctor about starting an annual testing schedule that includes: ■ Yearly fecal occult blood test (FOBT) or fecal immunochemical test (FIT) ■ Flexible sigmoidoscopy every five years ■ Double-contrast barium enema every five years ■ Colonoscopy every 10 years If you have any of these risk factors, talk to your doctor about starting colorectal cancer screenings earlier (around age 40): ■ Personal history of colorectal cancer or polyps ■ Strong family history of colorectal cancer or polyps ■ Personal history of chronic inflammatory bowel disease ■ Family history of a genetic colorectal cancer syndrome For more information about colorectal cancer and its screening tests, visit the American Cancer Society website at www.cancer.org* or Aetna InteliHealth at www.intelihealth.com. Click on Cancer in the Diseases and Conditions menu. 8 Climb the new food guide pyramid Research shows that eating the right foods is the key to preventing disease and health problems. In 2005, the U.S. Department of Agriculture (USDA) updated the Food Guide Pyramid by creating new rules. The new rules include healthy eating and exercise. The new pyramid, called MyPyramid, was designed to fit each person’s needs and tastes. To create your own MyPyramid Plan, visit www.mypyramid.gov.* Fats – should be limited. Get less than 10 percent of your calories from saturated fatty acids and less than 300 mg/day of cholesterol. Eat as little trans fatty acid as possible. Keep total fat intake between 20 to 35 percent of calories, with most fats coming from polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When choosing and cooking meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free. The new food plans use age, sex and activity level to help you create a healthy way to eat. The plans incorporate foods from the five food groups – grains, vegetables, fruits, milk, meats and beans – as well as oils. Grains – include foods made from wheat, rice, oats, cornmeal, barley or another cereal grain. Foods like bread, pasta, oatmeal and breakfast cereals are grain products. There are two types of grains – whole grains and refined grains. Whole grains (such as whole-wheat flour, oatmeal and brown rice) should make up at least half of the grains you eat. Vegetables – provide nutrients that are important for your health. They have important forms of fiber, potassium, folate (folic acid) and vitamins A, E and C. To get the health benefits of vegetables, you can eat them raw or cooked; frozen, fresh, canned or dehydrated; whole, cut-up or mashed. Fruits – are low in fat, sodium and calories, and they add potassium, fiber, folate (folic acid) and vitamin C to your diet. Eat fruits high in potassium such as bananas, prunes and prune juice, dried peaches and apricots, cantaloupe, honeydew melon and orange juice. Milk – includes all fluid milk products and many foods made from milk, like yogurt, cheese, pudding and ice cream. Cream cheese, cream and butter are not included because they keep little or none of the calcium from milk. Pay attention to the fat content of different types of milk (skim, one percent, two percent, whole) and make choices that are low fat or fat-free. 9 Meats and beans – include foods made from meat, poultry, fish, dry beans or peas, eggs, nuts and seeds. The best choices in this group are lean or low fat. Picking foods from this group that are high in saturated fat and cholesterol (such as fatty cuts of beef, pork and lamb; regular ground beef; regular sausages, hot dogs and bacon; lunch meats like regular bologna and salami; and duck) are not good choices. Fish – (such as salmon, trout, and herring) are high in a type of polyunsaturated fatty acid (PUFA) called “omega-3 fatty acids.” Eating fish high in omega-3 fatty acids can reduce the risk of heart disease. Oils – are fats that turn to liquid at room temperature, like vegetable and olive oils. It’s important to include oils in your diet because they are the major source of polyunsaturated (PUFA) and monounsaturated (MUFA) fats. They contain essential fatty acids necessary for health. Nuts, olives, some fish and avocados are naturally high in oils. Mayonnaise, certain salad dressings and soft margarine are mainly oil. Always check the Nutrition Facts label to make sure foods contain no trans fats. 10 Water – is an important part of your daily diet. Follow these tips to get the amount of water you need every day (six to eight glasses): ■ ■ ■ ■ Drink water even if you don’t feel thirsty. Drink one or two glasses of water 30 minutes to one hour before exercising. Drink another half glass 10 minutes before your workout. Finally, drink at least one glass of water after you finish exercising. Always talk to your doctor before starting an exercise program. Drink more water if your diet is high in fiber, protein or salt. Fruits, vegetables and soups are at least 80 percent water, and count toward your daily amount. Milk, diet sodas, unsweetened carbonated waters, most herbal teas, caffeine-free teas and decaf coffee can replace pure water. The same is not true of fruit juices and sugar-sweetened drinks. These other beverages still count as fluid sources, but their sugar content can slow down your body’s ability to absorb water. Don’t count coffee as a replacement. Healthy tips for eating out Stay fit for life Talk to your doctor More and more restaurants are adding healthy food choices to their menus. You can follow some of these tips when eating out: To make your overall health better, learn to combine a healthy diet with exercise. You should try to do at least 30 minutes of medium-force activity per day. There are many fun-filled activities you can do, including: Talking to your doctor will help you take greater control of your health and wellness. As you get older, be sure to tell your doctor about any changes you notice. This includes coughs that will not go away, new bumps or lumps or changes in bowel habits. ■ ■ ■ ■ ■ Translate the menu – Look for broiled, grilled, poached, steamed, roasted or baked foods. Avoid foods described as fried, crisp, sauteed, creamy, creamed, au gratin, escalloped or breaded. Half it with a friend – You won’t overeat if you split your appetizer and dessert. Portion control – Ask to have your “doggy bag” made in advance. You’ll only get a half order at the table. Or try ordering a half order or children’s portion as a meal. Eat your food in order – Start by eating the lowest calorie foods on your plate first. You’ll fill up and reduce calories. ■ Hiking ■ Gardening ■ Dancing ■ Golf ■ Bicycling ■ Swimming ■ Walking the family pet Physical activity can also help you feel better about yourself and reduce any sad feelings that you might have. Talk to your doctor before starting an exercise program. Balance your meal – If you really want a high-fat or high-calorie dish, balance it with healthy choices for the rest of the meal. 11 Additional resources Food Guide Pyramid* www.mypyramid.gov 2005 Dietary Guidelines for Americans* www.health.gov. Click on Dietary Guidelines for Americans 2005. Coping With Depression The Aetna Reawakening Center www.reawake.com Health Screening Information for Men www.intelihealth.com Click on Men’s Health and then Screenings and Doctor Visits. General Men’s Health www.intelihealth.com Click on Men’s Health. Exercise and Fitness, Weight Management, Nutrition www.aetna.com Click on Members: Public Information, Health and Wellness and then Living Well. 1 2 3 4 5 6 7 8 9 10 11 12 13 U.S. Centers for Disease Control and Prevention. Family History is Important for Your Health. Available at www.cdc.gov/genomics/public/files/print/FamHistFactSheet.pdf. Accessed January 17, 2006. American Diabetes Association. National Diabetes Fact Sheet. Available at www.diabetes.org/ diabetes-statistics.jsp. Accessed December 29, 2005. American Heart Association. Risk Factors and Coronary Heart Disease. Available at www.americanheart.org/presenter.jtml?identifier=4726. Accessed December 29, 2005. Prostate Cancer Foundation. Detection and Screening. Available at www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.47285/k.CCF1/ Detection__Screening.ht. Accessed April 17, 2006. National Diabetes Information Clearinghouse. National Diabetes Statistics. Available at www.diabetes.niddk.nih.gov/dm/pubs/statistics/index.htm#10. Accessed April 6, 2006. American Heart Association. Risk Factors and Coronary Heart Disease. Available at www.americanheart.org/presenter.jhtml?identifier=4726. Accessed April 6, 2006. Aetna InteliHealth. High cholesterol. Available at www.intelihealth.com/IH/ihtIH/ WSIHW000/8775/24049/201972.html?d=dmtHealthAZ. Accessed January 6, 2006. Centers for Disease Control and Prevention. Overweight and Obesity. Available at www.cdc.gov/nccdphp/dnpa/obesity/. Accessed January 17, 2006. National Heart, Lung and Blood Institute. Learn About BMI and Healthy Weight. Available at www.nhlbi.nih.gov/health/public/heart/obesity/wecan/learn-it/bmi-chart.htm. Accessed March 28, 2006. National Heart, Lung and Blood Institute. Limit Alcohol Intake. Available at www.nhlbi.nih.gov/hbp/prevent/l_alcohol/l_alcohol.htm. Accessed May 12, 2006. American College of Preventive Medicine – Screening for Skin Cancer Policy Statement. Available at www.acpm.org/skincanc.htm. Accessed May 11, 2006. Prostate Cancer Foundation. About Prostate Cancer. Available at www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.70617/k.8235/ Prostate_Cancer_Overview.htm. Accessed April 17, 2006. American Cancer Society. What Are The Key Statistics For Colorectal Cancer? Available at www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_ colon_and_rectum_cancer.asp?sitearea. Accessed July 17, 2006. 13 * Aetna is not affiliated with the American Cancer Society, the U.S. Department of Agriculture or the 2005 Dietary Guidelines for Americans. Reference herein to these websites does not constitute and shall not be construed to constitute endorsement of such entity/material by Aetna. Aetna does not control the content of www.cancer.org, www.mypyramid.gov or www.health.gov and cannot guarantee the accuracy or timeliness thereof. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Health Inc., Aetna Health of California Inc., Aetna Health of the Carolinas Inc., Aetna Health of Illinois Inc. and/or Aetna Life Insurance Company. Aetna does not recommend the self-management of health problems, nor do we promote any particular form of medical treatment. You should consult your health care provider for the advice and care appropriate for your specific medical needs. Information supplied by InteliHealth is for informational purposes only, is not medical advice and is not intended to be a substitute for proper medical care provided by a physician. While this material is believed to be accurate as of the print date, it is subject to change. 21.05.312.1 (7/08) ©2006 Aetna Inc.