Improving the Diet of Men, Reducing the Risk of Disease


Patients with obesity are at an increased risk of a number of diseases, including type 2 diabetes, IBD, and cardiovascular disease.

Food deserts and food inequality problems were issues that existed before COVID-19 that have only been made worse by the ongoing pandemic. With obesity rates climbing, there is plenty of concern that the pandemic has resulted in poor dietary decisions and habits that could exacerbate this growing issue.

And obesity is a well-known risk factor for plenty of negative outcomes, including cardiovascular disease, type 2 diabetes, and several other diseases and disorders.

In an interview with HCPLive®, Colleen Ereditario, MPH, RD, LDN, Program Manager, Healthy Food Centers, Allegheny Health Network, Megan Klucinek, Manager, Ambulatory Nutrition, Allegheny Health Network, and Tori Vallana, RD, LDN, Project Coordinator, Healthy Food Centers, Allegheny Health Network, spoke about how obesity is connected to different diseases and why diet is so important for men in avoiding some of these outcomes.

HCPLive: What are some of the diseases that can possibly be prevented with better diet decisions from men?

Ereditario: The main ones are obesity, heart disease and stroke, type 2 diabetes and some cancers. So eating a healthy diet, along with getting enough physical activity and sleep can help prevent overweight and obesity, which can then put people at risk.

HCPLive: Specifically in gastroenterology, diet is used both as a preventative measure and a treatment when someone develops a disease like IBD. How important is it to continue to promote gut health diets with gastrointestinal diseases in mind?

Ereditario: So when you have some gastrointestinal diseases, it's really important that you seek help from your doctor and also a registered dietitian, because everybody's plan is going to be individualized and different.

So you want to make sure you have a plan as far as your nutrition goes. And also make sure you're taking your medications as prescribed. But what you are eating can have a huge effect on your stomach with these type of issues.

A lot of times, dietitians will put you on a low residue diet. That limits foods that are higher in fiber. So those are suggested when someone has Crohn's or colitis flares.

But it is important to make sure you're getting foods that include probiotics like yogurt, and also prebiotics like bananas. And this is where you know working with a dietitian, they can help you come up with a meal plan and different ideas of what you can eat.

Some foods that you want to avoid with IBD symptoms could be and again, everyone's different, but some of these foods that can irritate your stomach can be milk and other dairy products, caffeinated drinks, carbonated drinks, alcohol, fruit and fruit juices, spicy foods, fried or high fat foods.

Normally you tell people you need to eat a high fiber diet like whole grains. But when you're having a flare up, you want to decrease the foods that are higher in fiber, like whole grain breads, raw vegetables, beans, anything thing with nuts or seeds that can irritate the stomach.

HCPLive: What are some of the common mistakes men often make in regard to their diet?

Klucinek: Oftentimes men are known for skipping meals, possibly just working through the day and waiting to have one meal. Of course they're hungry, and they'll just eat anything and not be really mindful of perhaps what they're eating and might overeat at one meal.

Also what's in that meal. So oftentimes, they're highly processed foods, eating out, foods that are high in salt, high in fat, and cholesterol and calories. That can be an issue that we often hear with men.

Also something that is different from the CDC is taking a look at alcohol intake. And men are two times more likely to binge drink than women are. 59% of men say in the past 30 days that they might have engaged in that behavior compared to 47% of women.

So not only do you have issues with calories and not eating because you're replacing liquid and maybe not the best judgment with what you might be eating. But also it can increase your risk for obesity and for different cancers and for liver disease.

And something kind of unique, maybe not to men only, is they might have been former athletes and used to training and working out and eating a certain diet and a certain portion size of food when they work out to make up the caloric needs that they would have.

They kind of keep up with that intake, but don't keep up with the exercise at that same time. So that can predispose us to diabetes and some of the chronic illnesses that Colleen had mentioned.

HCPLive: How concerning are the obesity rates among men, which obviously is related to cardiovascular disease, diabetes, and some other diseases? And are we actually seeing those rates come down a little?

Vallana: I always like to be positive. And this one, it's a little tough because we do see the obesity rates rising among men and women, particularly in the US. The Trust for America's Health, they took a look at those rates. And overall, we're at a 42.4% obesity rate in this country, for the last reported years of 2017 to 2018.

In 2008, just doesn't seem that long ago, but we were at 26%. If we keep going at this rate, this is not good for the whole country. And when we take a look at men, in particular, the latest CDC figures, one in three men are classified as being obese or overweight.

When we look at the age classes, the men who are ages 22 to 39, are coming in at 40.3%, obesity and overweight risk. To me looking at that, we have younger people that are experiencing obesity for a greater portion of their lives. And where might that lead them more, it's a little different than in previous generations.

And then for men 40 to 59, that rate is 46.4%. And men 60 and over is 42.2%. So we look at that perfect storm of increase of age and increase of weight that might leave us at greater risk.

And I think one positive thing though, is people have used the pandemic for different reasons.

During the pandemic, we saw folks that maybe took more time for eating and exercising.

But we also have more data to show that patients who were more obese had more difficulty recovering from COVID-19 and increased severity of COVID-19. So hopefully these things will make all men and women but particularly men take a look at their health and go to the doctors more and really start to address these things so we see the rates go down.

HCPLive: Are you afraid during the pandemic that many people developed poor dietary habits and poor routines that some of these habits may stay with people?

Vallana: Working at the healthy food centers, we focused on patients experiencing food insecurity. So coming out it from that angle, just seeing the amount of job loss or hours cut, you know, people are struggling with their budget, that's less money to spend on food.

If you're on that limited budget, you're probably not buying the fresh fruits and vegetables or things that are going to expire really quickly.

So I think it definitely did lead to poor diet quality among the existing food insecure population. And then we saw a lot of people that became food insecure throughout the pandemic.

I'm sure that it negatively impacted their diet quality as well. But beyond just that, a lot of people move to remote work through the pandemic. So just staying at home a lot more not getting out as much.

But hopefully, now that things are opening up, more people are getting back outside the weather's nicer. They're starting to get back into those healthy habits. And that's something that as dieticians, we're always trying to encourage.

HCPLive: How does food access impact the risk of disease in patients? And what can be done to improve these access problems across the country?

Vallana: There's definitely an association between lack of food access and poor diet quality and poor health outcomes, which is partially why the healthy food centers exist is to try and overcome that gap.

As dietitians, we're always telling people specifically how to eat or your doctor wants you to eat in a certain way. But if you can't afford those foods, or can't even get access to those foods, how are you supposed to be successful?

So we want to make sure we're getting people access to not just food but nutritious foods and foods that are appropriate for them and for their diet. So how do we fix that problem is a little bit of I don't know if I can solve that in this interview.

But on a smaller scale, doing things like the healthy food centers, giving people, just directly getting people the food, whether it's a produce distribution of food pantry, different forms of food distributions, but also the education that goes with it.

So just teaching people how to shop on a budget, what foods are low cost, but still going to be good for you how to stretch their food budget a little bit.

I think that's how we bridge it on a smaller scale. And then on a larger scale, looking at inequities and food access, looking for food deserts, how can we make sure that people have grocery stores in their area and have grocery stores that are affordable and that they can get you there on a bus line.

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