Updated 20 March 2015

'Boep' worse for older men than low testosterone

A study suggests that for older men, having a big belly is more closely tied to general health problems than having low testosterone levels.

For older men, having a big belly is more closely tied to general health problems than having low testosterone levels, a new study suggests.

Researchers have known that obesity is linked to lower testosterone among men. But it's been less clear how each of those factors relates to men's well-being, Dr Marianne Andersen told Reuters Health in an e-mail. She worked on the study at Odense University Hospital in Denmark.

In otherwise healthy men, an increased waist may be more important for some aspects of quality of life than low testosterone levels, as long as those low levels are still in the normal range, Andersen said.

Declining well-being

For their study, Andersen and her colleagues asked 598 Danish men ages 60 to 74 about their quality of life using a questionnaire called the Short-Form 36, or SF-36. The questionnaire measures general health, including ability to perform physical activities, pain, vitality, social functioning and emotional and mental health.

The researchers also measured men's body fat, including stomach fat, and testosterone levels. Four in ten were obese.

The analysis suggested men's waist size was most closely tied to their quality of life – as waists grew, well-being declined.

Modest association

Testosterone, on the other hand, was "only modestly" associated with quality of life, according to findings published in Age and Ageing. "It is really no surprise that obese men score worse than thin men on the SF-36," Dr Bradley Anawalt told Reuters Health in an e-mail.

But, he said, that particular questionnaire "is not designed to capture the quality of life issues that would relate to testosterone and men's health." Anawalt is an endocrinologist at the University of Washington School of Medicine in Seattle.

He was not involved in the new research. "If you are a generally healthy man with low testosterone levels, you will have a normal score on SF-36 because that questionnaire does not ask questions about sexual function and it does not quantify strength, bone mass and other organs or functions affected by testosterone," Anawalt said.

Get off the couch

Andersen said that's not just a problem with the questionnaire her team used. "There is a general agreement that no questionnaire may distinguish between patients with normal or low testosterone levels," she said.

"Many men with normal testosterone levels have bad scores and men with low testosterone levels have good scores." That's in part because men don't necessarily feel different when they have low bone mass, one of the symptoms of low testosterone, for instance.

Anawalt said it's essential for middle-aged men who are sedentary, overweight and perhaps have slightly low or low-to-normal testosterone to exercise regularly. Even a modest amount of weight loss can improve their health and quality of life and will raise their testosterone – or "T" – levels.

"On the brink of the Super Bowl when hundreds of millions of men will spend hours eating, drinking and watching pigskin leather being booted off of a tee, we need them to be focused on getting off the couch and moving (more) than we need them to be asking 'Would I feel better if I had a higher T level?'" Anawalt said.

Read more:

Men with belly fat at risk for osteoporosis

Belly or hip fat? All in the genes

Belly fat triples stroke risk



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