Chapter 1

Keeping Your Body in the Game through Extra Innings

IN THIS CHAPTER

Getting familiar with fatal diseases and other lifestyle challenges

Learning about lifestyle changes that lengthen life

Setting health goals and trusting your doctor so your changes last

Here's a fun fact that's not actually fun at all: in 2023, American men lived on average 5.3 fewer years than women. That's an improvement from the COVID-19 pandemic peak of 5.8 years in 2021, but it's still a pretty sobering reality check. And this holds true globally - the gap's the same for 2023.

Women living longer than men isn't some unavoidable biological destiny. Sure, women have some built-in advantages. They have some protection from estrogen and their immune systems, they're less likely to drive 95 miles per hour in a 65 mph zone, and they probably don't think "chest pain" is something you can just walk off or rub some dirt on. And genetics is certainly a contributor to diseases men develop. But the real causes of this longevity gap aren't written in our DNA; they're largely written in our daily choices.

Although the main causes of death are the same for men and women, men die more often from heart disease, cancer, and unintentional injuries (also called accidents). Men are more likely to skip doctor visits, ignore symptoms, and treat their bodies like they don't need regular maintenance.

The good news is, most of these deaths are preventable. And you're already ahead of the curve because you're reading this book. So let's dive into why men are checking out early and, more importantly, what you can do to change course.

Dodging the Big Killers

Although the leading causes of death for men have fluctuated a little since 2010, when the gap between men's and women's lifespans was smallest, the top three contributors have stayed steady - heart disease, cancer, and accidents. (Well, COVID-19 pushed in from 2019-2021, but the death rates plummeted after 2021, so we're focusing on diseases that have had a consistent and sustained impact on men's lifespans.)

The good news is, none of these three diseases (along with a few buddies that are also sending men to early graves) have to be death sentences if you get ahead of things early.

Avoiding heart disease

Heart disease kills more men than anything else - nearly 300,000 American men in 2021. Even guys in their 40s are having heart attacks at rates that would make your grandfather nervous. Although genetics are a component, men develop heart disease mostly because of their lifestyle choices. They're more likely to smoke cigarettes, eat a poor diet, get too little exercise, and ignore stress.

Here's a two-step action plan to help your heart right now:

• Know your numbers. The American Heart Association (www.heart.org) sets blood pressure targets under 130/80, so check yours and see where you stand. If you don't own a home monitor, you can get one for less than $35, or head to your local drug store's pharmacy and use theirs for free. Check your blood pressure weekly, not obsessively. Find more about blood pressure in Chapter 15.
• Move your body for 150 minutes per week, and walking counts. Find out what else counts in Chapter 5.

Take a look at Chapter 15 to get up to speed on heart disease and additional steps you can take to prevent it.

Reducing cancer risks

Cancer is the second leading killer, with close to 250,000 American men succumbing in 2021. Men often avoid health screenings, which prevent them from finding issues early enough for more successful treatment. Women get mammograms, pap smears, and regular checkups because they've normalized preventive care. Meanwhile, men treat colonoscopies like medieval torture. (Before you've had your first one, it certainly can appear that way.)

Some of the big cancers killing men are lung and prostate, and testicular cancer is the most common cancer in guys younger than 35. When screened and caught early, five-year survival rates for many cancers can be above 85 percent, but when caught late, the rates can be less than 35 percent.

You can also significantly reduce your cancer risk by not smoking, changing your diet, and getting enough moderate exercise. Take a look at Chapter 16 for more information about cancer and ways you can reduce your risks.

Steering clear of accidents

This category sounds easy to steer clear of, but in the United States it's actually the third leading contributor to men's deaths, claiming about 100,000 lives. Unintentional injuries, also known as accidents, is medical speak for drug overdoses, car accidents, falls, and workplace injuries - basically, all the ways men hurt themselves through risk-taking or poor judgment.

Drug overdoses are driving this trend; men are two to three times more likely to die from overdoses than women. Opioid addiction often starts legitimately - back surgery, injury, or dental work creates pain that needs a serious analgesic - but escalates quickly. If you're prescribed opioids, use them exactly as directed and dispose of leftovers immediately. If you're struggling with addiction, get help. This isn't a moral failing; it's a medical condition with effective treatments, and if left untreated, could literally kill you.

Vehicle accidents remain a major killer in part because men drive more aggressively and are involved in more fatal crashes than women. Some solutions are simple: slow down, buckle up, and put the phone away. Others are more difficult - if you're a truck driver, simply getting a lot more road time puts you at greater risk for fatal accidents.

Workplace safety matters too. The Bureau of Labor Statistics reports that men account for nearly 90 percent of workplace fatalities, many of them related to equipment operation or falls. If you work in construction, manufacturing, or any high-risk job, follow safety protocols religiously if you want to reduce your risk of dying early.

The bottom line on accident-driven causes of death? They're largely preventable. Chapter 17 has additional suggestions for how you can avoid becoming a statistic.

Rounding out the other fatal influencers

Overwhelmingly, heart disease, cancer, and accidents are the causes of men's deaths. To a much lesser degree, men die from stroke (Chapter 18), chronic respiratory diseases like COPD and asthma (Chapter 19), diabetes, and Alzheimer's disease (see Chapter 20 for both). Although genes have a stronger role in developing some conditions than others,in many cases you can meaningfully reduce your risks of developing each. Take a look at the chapters we've noted to get more information.

Addressing the Mental Health Elephant in the Room

Mental health issues are making men suffer and are contributing to shorter and less satisfying lives. A guy pretending everything's fine isn't a strategy that works. Every journey of a thousand miles starts with one step, though, and you reading this book is that step if mental health is a concern for you.

Stress

Chronic stress doesn't just make you irritable; it literally rewires your body for failure. Chronic stress increases heart attack and stroke risk.

Men are particularly bad at managing stress because they're conditioned to "power through" instead of addressing the root causes.

Stress hormones such as cortisol wreck your cardiovascular system, suppress your immune function, and mess with your sleep. Men are more likely to cope with stress through drinking, smoking, or working longer hours - all strategies that make the problem worse and contribute to the development of other fatal diseases, too.

Even quick and easy stress reduction techniques can make a difference while you're sorting out and fixing the root causes. Next time you're feeling stressed or overwhelmed, try ten minutes of deep breathing, take a walk around the block, or call a friend. Even brief stress-reduction activities can lower cortisol levels significantly. Head to Chapter 7 for more on stress.

Anxiety and depression

Anxiety in men frequently shows up as physical symptoms, such as chest tightness, headaches, or stomach issues, making many guys think they have a medical problem rather than a mental health issue. Male depression shows up as anger, irritability, substance abuse, or emotional withdrawal - not what you expect to see for depression.

Compared to women, men are less likely to seek help for mental health symptoms, often because they don't recognize these signals for what they really are. The good news is that both depression and anxiety are highly treatable conditions, either on your own or with the help of a professional.

Getting help isn't weakness; it's maintenance. Just like you'd see a mechanic for a broken transmission, you should see a mental health professional for a broken mood. We discuss several different types of therapy in Chapter 7, as well as self-help actions you can take.

Talking about Sexual Health

If you don't understand the basics of the male...