Low Testosterone Associated With Obesity and the Metabolic Syndrome Contributes to Sexual Dysfunction and Cardiovascular Disease Risk in Men With Type

+ Author Affiliations

¹Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, California
²London Bridge Hospital, London, U.K.
³Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital, and the Department of Metabolism, University of Sheffield Medical School, Sheffield, U.K.
⁴Geriatric Research, Education and Clinical Center, V.A. Puget Sound Health Care System, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
⁵Department of Urology, Mayo Clinic, Rochester, Minnesota
⁶Departments of Psychiatry, Reproductive Medicine, and Urology, NY Weill Cornell College of Medicine, New York, New York
⁷Department of Urology, Boston University School of Medicine, Boston, Massachusetts
⁸Clinical Andrology/Centre for Reproductive Medicine and Andrology, University Clinics of Muenster, Muenster, Germany
⁹Departments of Medicine and Molecular and Cellular Biology, Baylor College of Medicine, St. Luke’s–Baylor Diabetes Program, Houston, Texas

Corresponding author: Christina Wang, wang@labiomed.org.

Men with obesity, the metabolic syndrome, and type 2 diabetes have low total and free testosterone and low sex hormone–binding globulin (SHBG). Conversely, the presence of low testosterone and/or SHBG predicts the development of metabolic syndrome and type 2 diabetes. Visceral adiposity present in men with low testosterone, the metabolic syndrome, and/or type 2 diabetes acts through proinflammatory factors. These inflammatory markers contribute to vascular endothelial dysfunction with adverse sequelae such as increased cardiovascular disease (CVD) risk and erectile dysfunction. This review focuses on the multidirectional impact of low testosterone associated with obesity and the metabolic syndrome and its effects on erectile dysfunction and CVD risk in men with type 2 diabetes. Whenever possible in this review, we will cite recent reports (after 2005) and meta-analyses.

Epidemiological studies of low testosterone, obesity, metabolic status, and erectile dysfunction

Epidemiological studies support a bidirectional relationship between serum testosterone and obesity as well as between testosterone and the metabolic syndrome. Low serum total testosterone predicts the development of central obesity and accumulation of intra-abdominal fat ( 1– 3). Also, low total and free testosterone and SHBG levels are associated with an increased risk of developing the metabolic syndrome, independent of age and obesity ( 1– 3). Lowering serum T levels in older men with prostate cancer treated with androgen deprivation therapy increases body fat mass ( 4). Conversely, high BMI, central adiposity, and the metabolic syndrome are associated with and predict low serum total and to a lesser extent free testosterone and SHBG levels ( 1– 3, 5). Because obesity suppresses SHBG and as a result total testosterone concentrations, alterations in SHBG confound the relationship between testosterone and obesity.

Low total testosterone or SHBG levels are associated with type 2 diabetes, independent of age, race, obesity, and criteria for diagnosis of diabetes ( 6, 7). In longitudinal studies, low serum total and free testosterone …

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Acid Reflux? Eat an Apple!

By Bob Barney:
I like many people have acid reflux. Being overweight and eating too much food at one time are major triggers for the disease to occur. However, I think that like many other ailments that affect us, genetics probably also plays a role, as well as the modern "factory" foods that we consume. I read some tips on stopping the pain of acid reflux and want to share them. Try them, and let me know how you make out.

An Apple a day?
We have all heard that an apple a day keeps the doctor away. That may be true, as apples seems to be one of God's most nutritious foods one can consume. However, after meals or even after the first signs of acid reflex- eat an apple! There are a lot of over-the-counter and prescription options available for treatment of acid reflux, but apples are easy to find, incredibly inexpensive, and for some individuals---an easy fix. Acid reflux generally produces a burning sensation in the individual's upper abdomen, chest and/or throat areas. At one time, this condition was called acid indigestion. Apples work because they help neutralize the stomach acids, which in turn, help strengthen the LES valve. (Read more: Acid-Reflux Cure Using Apples | eHow.com http://www.ehow.com/way_5329848_acidreflux-cure-using-apples.html#ixzz1PjcLbE6Q)

Curing acid reflux with apples is simple. Just eat one-to-two apples a day. Try eating apple slices before going to bed and in-between meals. That being said, the old-time saying, "an apple a day keeps the doctor away," is starting to sound more valid for many individuals experiencing acid reflux. You can also try adding apple slices or pieces to unflavored yogurt. Yogurt also naturally fights acid reflux. Eating this mixture once or twice a day should produce results in just a few days. Many individuals find that eating the mixture with dinner is particularly beneficial.
According to Dr. Brian Fennerty, who is a gastroenterologist, stick with organic apples, as they tend to be more easily digested.

Apple Cider too?
Apple cider vinegar can also be extremely helpful when it comes to fighting acid reflux. It's sort of like fighting a hangover with "hair of the dog." In other words, using acid to fight acid. Some individuals find that drinking two teaspoons of organic apple cider vinegar three times a day is very helpful with acid reflux. Other tips to remember include watching and maintaining a healthy weight and eating smaller meals. Make sure your final meal is at least three or more hours before bed. Avoid lying down after a meal or eating. Raising the head of your bed may also be beneficial if you experience acid reflux during sleep. This can be accomplished by placing wooden or cement blocks under the feet of the head of your bed. You can also raise the head of your bed by inserting a foam wedge between the mattress and the box spring in order to elevate your body during sleep from the waist up.

Other remedies:
Ginger also helps with acid reflux, and stewing ginger to make a tea works great just before bedtime. Chewing gun (with Xylitol) during the day works wonder in aiding digestion. Most do not understand that digestion is a process where enzymes and bacteria in your body, along with your own "stomach juices" breaks down food into a form of energy that your body can use to fuel itself. These juices, enzymes and bacteria are not only found in the stomach, but much are produced in your mouth! Chewing food slowly, or chewing gum, produces enzyme rich saliva that aides you stomach and makes it work a lot less refining your food into energy!

Why Organic?
Have you ever cut an apple and watched it turn brown? We all have! That natural process is a foe to the food industry! People don't want to eat what looks to be rotten apples! People cut apples, serve them and within minutes they are brown, un-appealing and thrown away. Food companies have spent a fortune to stop this from happening. From genetically modified apples, to radiation and other ways to stop the process. The reason why the browning occurs is that the apple supplies it's own unique enzyme to help your body turn it into fuel! Without this enzyme (which you do not produce) the apple can't be digested! Eating such apples are no better for you than eating a Big Mac! Organic apples (or for that matter any apple that turns brown within minutes) are what you must consume to fix acid reflux. So eat apples and foods in general as close to the state God made them for the best results.