Aging in Men and Nutrition
Note: In this article, the acronym AMAB (Assigned Male At Birth) will be used to refer to individuals assigned male at birth. The processes described concern AMAB individuals—those with testes who produce testosterone—as this is a natural age-related process for people with male sex organs. We acknowledge that, although some men do not experience andropause, they may still experience symptoms related to hormonal changes and could benefit from the interventions mentioned in this article.
Testosterone and Aging
The primary sex hormone in Assigned Males at Birth (AMAB) is testosterone. During childhood and adolescence, this hormone is essential for the development of facial and body hair, muscle strength, and change in voice, also known as the male characteristics of puberty. It also plays a role in the production of red blood cells and sperm. Testosterone has protective functions in the maintenance of heart health, bone density, and muscle mass. It also has beneficial effects on mood and helps to regulate sexual function.
The mechanism and effects in Assigned Females at birth (AFAB) have long been documented and studied, and many people may conclude that the impact of hormonal changes AMABs and AFABs are the same. However, while there are some similarities in the changes in organ function and tissue distribution, ageing-related changes in hormones in AMAB and AFAB people are effectively different. Andropause is not simply a “male menopause”, although it is also a natural part of ageing, like menopause.
In people who experience menopause, there are well-documented symptoms that accompany a plummet in the hormones estrogen and progesterone at the start of menopause. These symptoms persist until the end of menopause, marked by the last ovulation cycle and thus the last menstrual period. In contrast, there is a much slower decline in testosterone in people who experience andropause which occurs progressively throughout the years rather than a sudden drop at a certain point. Starting at around 40 years of age, most AMABs begin to experience a gradual decrease in testosterone levels of about 1-2% of total testosterone per year.
Symptoms of this gradual decrease in testosterone include decreased energy levels, changes in memory and concentration, hot flashes, decreased libido and erectile dysfunction. The protective effects of testosterone for heart health, bone density and muscle mass also slowly decline, which can lead to an increased risk for certain health conditions such as cardiovascular disease and osteoporosis, amongst others. Some lifestyle factors can help in the maintenance of testosterone levels:
- Adequate level of physical activity: aerobic training causes an increase in heart rate, which can help to boost the production of testosterone. Resistance training also has positive effects on testosterone levels. Health Canada recommends at least 150 minutes of moderate aerobic activity per week.
- A balanced varied diet, as discussed in the “Nutrition and Andropause” section
- Moderation of alcohol and drug use
Nutrition and Andropause
In general, a balanced diet with a variety of foods from all food groups is recommended to help with our growth and development and for the maintenance of our body’s functions. One way to follow this recommendation is to use Canada’s Healthy Plate as a reference: ½ of the plate is filled with vegetables and fruit, ¼ of the plate with a source of protein, and ¼ with grain products. Eating a variety of foods will allow us to meet our nutrient needs, and provide us the energy to continue doing the things we enjoy. Having an adequate protein intake especially helps to maintain our muscle mass.
While progressive muscle loss occurs naturally as we age, the slow decline in testosterone in people who experience andropause contributes to this muscle loss more than hormonal changes do in people who experience menopause. Therefore, meeting the recommended amount of daily protein intake is beneficial in preserving and keeping our body strong.
A decrease in testosterone levels, similar to the decrease in estrogen in people who experience menopause, can lead to lower bone density and thus increased fragility. Osteopenia and osteoporosis are well-known to be at high risk for people going through menopause, with about 50% of individuals experiencing osteopenia and 30% developing osteoporosis. However, it is important to note that about 20% of people who experience andropause also suffer from osteoporosis.
Calcium and vitamin D: Calcium is an essential mineral for building and maintaining bone density. Vitamin D plays a key role in helping the body absorb calcium into the bloodstream. Health Canada recommends a daily intake of 1000 mg/day of calcium (1200 mg/day for people aged 70 and over) and 600 IU/day of vitamin D (800 IU/day for people aged 70 and over). Food sources include:
- Calcium: dairy products, fortified foods, canned fish with bones, leafy green vegetables, nuts, and seeds.
- Vitamin D: fatty fish (salmon, mackerel, sardines), egg yolks, certain red meats.
Importance of dietary monitoring: Consulting a nutritionist can help you develop a meal plan tailored to your needs. If you have any deficiencies, supplements may be recommended. Regular health checkups are also essential for detecting signs of osteopenia, osteoporosis, or other age-related conditions.
Mélissa Mcallister, Nutritionist, RD
