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
Sales of testosterone products have shot up in recent years (see
Reuters Health story of June 4, 2013 here: http://reut.rs/1eWVWGK.
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
"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,
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,
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