Belly fat worse for older men than low testosterone

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[January 18, 2014]  By Shereen Jegtvig

NEW YORK (Reuters Health)  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 email. 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.

Sales of testosterone products have shot up in recent years (see Reuters Health story of June 4, 2013 here: Treatment may be appropriate for men with seriously low testosterone, but these products are marketed to a much broader group, including men who are just tired or depressed.

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. 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 email.

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.

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"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.

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.


Age and Ageing, online Dec. 29, 2013.

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