We are celebrating men’s health month because at Te Atatu Toasted we are passionate about the wellbeing of all our husbands and partners, fathers, sons, brothers and friends.
We take a closer look at some of the health issues affecting Kiwi men.
What you need to know about cholesterol
Cholesterol is complicated – our bodies need some cholesterol to make hormones, vitamin D, and the bile acids that help you digest fat. But when we have too much, we increase our risk of health problems such as heart disease, heart attacks and stroke.
High cholesterol can affect both men and women and it’s common for cholesterol levels to rise with age. But it’s often a problem for men earlier in life. That’s because the estrogen women produce prior to menopause has a protective effect on the heart, partly due to its ability to help regulate cholesterol levels.
Ministry of Health figures show that last year there were 428,000 New Zealand adults diagnosed with high cholesterol.
So here are a few of the things you need to know about cholesterol to manage the impact it can have on your health.
What is cholesterol? Cholesterol is a waxy, fat-like substance made in the liver and other cells. It’s also found in certain foods, such as dairy products, eggs, and meat.
There are two types of cholesterol:
Low-density lipoprotein (LDL cholesterol) - sometimes called 'bad cholesterol'. When you have too much LDL cholesterol it builds up in the arteries (the blood vessels that carry blood and oxygen around the body).
The build-up of cholesterol causes lumps of hard fat called plaque to form on the artery walls. These can break off, block the artery, and cause heart attacks and strokes.
High-density lipoprotein cholesterol (HDL cholesterol) -the 'good' cholesterol. It works like a cleaner, carrying LDL cholesterol out of the arteries to your liver, where it is broken down and used by the body.
There is also another type of fat in our bodies - when we eat or drink our body turns any energy (calories) that it doesn't need into triglycerides, which are then stored in fat cells.
How is cholesterol measured? You can’t tell or feel if you have high cholesterol. The only way to check your cholesterol levels is to get a blood test. Your doctor can arrange for you to have a test at your closest laboratory and some pharmacies offer a finger-prick test to check cholesterol levels.
There isn’t a normal level that applies to everyone. Your ideal cholesterol level depends on your overall risk of heart attack and stroke but general guidelines in New Zealand for acceptable blood cholesterol levels are:
LDL-cholesterol – less than 2.0 mmol/L
HDL-cholesterol – greater than 1.0 mmol/L
Triglycerides – less than 1.7 mmol/L
Total cholesterol – less than 4.0 mmol/L
Total cholesterol/HDL ratio – less than 4.0.
What causes high cholesterol? There are some risk factors for high cholesterol we can’t change – these include family history, age and certain medical conditions such as kidney or liver disease, or hypothyroidism.
But there are lifestyle factors that we can change, such as:
Eating too much food high in saturated fats, like red meat, butter, cream, and other dairy products
Eating too many foods with refined sugars, such as sweets, baked goods, white bread and fizzy drinks
Drinking too much alcohol
Not being active enough each day
Having too much body fat, especially around the middle
Lowering your cholesterol
Here are some tips from the Heart Foundation:
Eat heart-healthy food
What you eat can make a big difference to your cholesterol levels.
Cut back on foods high in saturated fats like:
And eat a wide variety of heart-healthy foods like:
nuts and seeds
fruits and vegetables
Drink less alcohol
Drinking too much alcohol can increase your LDL cholesterol and triglycerides. So drinking less is a good way to lower your cholesterol.
The Ministry of Health recommends no more than 10 standard drinks per week for women and no more than 15 for men. One standard drink is equal to:
a standard can of 4% beer (300ml)
a small glass of wine (100ml)
a small single shot of spirits (25mls)
If you have high cholesterol or you've been diagnosed with a heart condition, you may need to drink less than this.
Smoking makes your LDL cholesterol (bad cholesterol) stickier and reduces the amount of HDL cholesterol (good cholesterol) in your blood. It also damages the artery walls. This increases the build-up of plaque in your arteries and can cause risk of heart attack and stroke.
Quitting smoking is a great way to lower your cholesterol levels and reduce your risk of heart disease.
Sitting less and being more active are great ways to reduce high cholesterol. This doesn’t mean you have to join a gym or take up running – it just means you need to move your body more throughout the day. Ideally you should do 30 minutes of activity a day.
You could try:
using the stairs not the lift
parking 10 minutes away from your work or getting off the bus a stop early
walking the dog twice around the park instead of once
Your doctor may recommend that you take medication to lower your cholesterol. If you take this medication as directed it helps lower your chance of having a heart attack or stroke.
Usually this will be from a group of medications called statins.
The benefits of taking a statin usually outweigh any side-effects. If you experience unpleasant side-effects, talk to your doctor about them. Sometimes they can change the type of statin that you're on or adjust your dose. Never stop taking your cholesterol medication without talking to your doctor first.
Better mental health for Kiwi men
Many men in New Zealand find it tough to talk about mental health issues.
We know that because Kiwi males reported lower rates of depression and anxiety than females but accounted for more than three-quarters of suspected suicides in New Zealand last year.
Ministry of Health figures show that of the 607 suspected suicides in 2021, 472 were men and 135 were women.
If you are a man struggling with anxiety or depression or somebody that wants to support a partner, father, son, mate or colleague, there are loads of online resources and support groups that can help.
One in eight New Zealand men will experience serious depression during their lifetime. The Mental Health Foundation’s Men and Depression pamphlet provides useful information on what depression is, its symptoms, the treatment options available, self-help tips, and how to get help.
It has a long list of possible signs of depression – here are just a few
Feeling tired, having no energy
Feeling irritable, restless or ‘on edge’
Anger and hostility towards others
Feeling isolated and withdrawing from whānau and friends
Losing interest in work, family/whānau and things you used to enjoy
Sleeping difficulties – difficulty getting to sleep, waking too early in the morning, waking through the night or oversleeping
Headaches, other aches and pains or digestive issues
Loss of interest in sex or sexual performance
Drinking or using drugs too much
Risky or reckless behaviour, such as dangerous driving
Feeling dejected, empty or numb, often first thing in the morning
Thoughts of suicide
When it comes to getting help, the Mental Health Foundation recommends starting with your GP or Māori hauora/health provider. Once you have had a check up to rule out whether these issues are caused by physical health problems, your health provider can guide you to get the help and support you need.
Talk to someone: talking with someone you trust about how you are feeling can help you feel less alone. Sometimes we need the view of a friend or loved one to see what we are putting out there.
Eat well. The link between food and mood is well-known: what you eat affects your mental wellbeing. You can up your mental wellbeing by making changes to your diet, and luckily, the same eating habits that keep you mentally well are those that support your physical health too. A healthy diet is such a big part of making you feel good, and even making great food can be uplifting.
Stay physically active. The powerful link between body and mental health means exercise is one part of your recovery that you can totally control. Start small but make it regular, get outside more, make better habits.
Alcohol and other recreational drugs need to be avoided as they won’t make you better. Avoiding these substances, especially if they are part of the problem, will help you feel better sooner.
Stay connected to the people who you love and who matter. Build on these whānau and friend links, fall back on them, but keep them.
Remember that asking for and getting help is a sign of strength, courage, kaha.
You are not alone There are men throughout New Zealand dealing with mental health issues and it can be useful to talk to someone who understands what you are going through.
Essentially men.net lists some great support networks around the country. But if sitting around talking isn’t your thing, joining a local Menzshed group might be a good way to connect and chat with other men while carrying out practical tasks. Many Menzshed groups invite local health professionals to give talks about health issues impacting men.
There are also several websites where men share their stories online.
Aotearoa NZ Tough Talk provides short documentaries and tools focused on men’s mental wellbeing. Men share how they improved their wellbeing and how they have taken a fresh look at how men are taught to think and behave in New Zealand, how to be vulnerable, mindfulness and finding a sense of purpose.
Depression.org.nz also has video stories that can give strength and hope to men going through a tough time.
Tackling important conversations with men in your life If you are concerned that a man you know may be struggling with mental health issues, the NZ Movember site has some great tips on starting a conversation.
You can’t fix someone else’s problems, but you can be there for them. Sometimes listening is the most helpful thing you can do. You won’t make things worse by asking someone how they’re doing.
Lifeline has health professionals and highly trained volunteers answering calls on its helpline 24 hours a day. Call 0800 LIFELINE (0800 543 354) or send a text to HELP (4357).
If you, or someone you know, may be thinking about suicide, call the Suicide Crisis Helpline for support on 0508 828 865.
Depression.org.nz also has a helpline available 24 hours a day – call 0800 111 757 or text 4202.
Beat bowel cancer
New Zealand has one of the highest rates of bowel cancer in the world and men are at increased risk of bowel cancer compared to women. Every year, more than 3,000 New Zealanders are diagnosed with bowel cancer and more than 1,200 die from it.
And you are never too young to be affected – more than 350 people under 50 are diagnosed with bowel cancer each year.
We talked to Waitemata Health General and Colorectal Surgeon Andrew Moot about why Kiwi blokes fare so badly in the bowel cancer statistics and what men can do to minimise their risk of dying from this disease.
Why do we have such a high rate of bowel cancer and why are men at higher risk?
Bowel cancer is a disease common in developed countries and it’s thought that the main contributing factor is the diet that we have in the west.
There are genetic conditions that can increase the risk, and this may be a significant factor in up to 20 per cent of bowel cancers, although currently we are able to identify the genetic link in only about five per cent of those.
The World Health organisation has identified processed meat as a carcinogen - people who consume more than 500g of processed meat per week had a higher rate of colorectal cancer. It is less clear whether red meat is carcinogenic, as it may be the nitrates in the bacon and sausages that are more the problem than the meat itself.
Bowel cancer is more common if you are overweight, and live a sedentary lifestyle, and smoke or drink too much. Men are more likely to smoke or drink than women. Men have more ‘visceral fat’, that is fat around their abdominal organs, and this visceral fat is associated with a higher risk of colorectal cancer. A New Zealand man is estimated to have a one in 15 risk of developing bowel cancer at some point in their life! Women are not too far behind, with about a one in 20 lifetime risk of developing colorectal cancer.
Men are especially more likely to develop rectal cancer than women.
he uptake of bowel cancer screening by men has been demonstrated to be lower in NZ and the UK. Women, of course, are more used to screening because they are offered cervical and breast cancer screening, both of which require uncomfortable and rather personal examinations. Men who participate in bowel cancer screening are more likely to benefit, so we do need to encourage men to accept the invitation to participate in our screening programme, currently available to all New Zealanders aged 60 to 74.
What are the symptoms of bowel cancer?
The symptoms of bowel cancer include rectal bleeding, a persistent change in bowel habits, and also weakness and fatigue that occurs if your blood count is low (anaemia) because you are slowly but persistently losing blood
A cancer can slowly ooze blood, and if that is in your colon you will probably not be able to notice it simply by observing your bowel motions. This is why screening tests look for occult blood in the stool - that is blood in your poo that you cannot see with your own eyes. If you are feeling tired and easily fatigued for no good reason, you may be low in iron or anaemic which is detectable on a blood test.
Rectal bleeding is really common and is most often from a benign anal cause such as a haemorrhoid (piles). You should report bleeding to your doctor so they can check carefully if there is an obvious benign cause. Dark red blood or blood mixed in with the stool is much more concerning then bright red blood (like from a fresh cut) on the toilet paper. A rectal cancer can have a very similar bleeding pattern to a haemorrhoid. Get your doctor to examine you to confirm the source of the bleeding.
A change in bowel habit is also a symptom of bowel cancer. Usually a change in bowel habit is due to changes in what we eat or if we get food poisoning. But if you have diarrhoea that persists for more than a month, or even if you are just passing your bowel movements more frequently without them being loose at all, this could be a symptom of bowel cancer and should be reported to your GP.
It should be noted that weight loss and pain are not a feature of early (more likely curable) bowel cancer. These symptoms are not specific for bowel cancer, and most patients with these symptoms are likely to have another cause. But the earlier bowel cancer is diagnosed the better the outcome, so see your doctor about your bowel problems.
When should men (and women) get checked for bowel cancer, how should they do it and how often do the tests need to be repeated?
There is a rising incidence of rectal cancer in younger people, so if you have the symptoms above then you should get checked even if you are a relatively young adult. The older you are the more likely you are to have cancer as a cause for your symptoms. Men are more likely to get rectal cancer. Young men beware!
If you have a family history of bowel cancer, especially more than one close relative (parent, brother or sister) with bowel cancer or a close relative under age 55, then you should discuss a referral for a colonoscopy with your GP because you are at least three times more likely to develop bowel cancer than someone who has no family history.
For everyone else who has no symptoms or strong family history of bowel cancer, screening is offered currently in New Zealand to all adults aged 60 to 74. This is in the form of a poo test which is done in the comfort of your own home and posted away for testing. It is checked for blood and if blood is identified you will be offered a colonoscopy.
Take up the invitation and do your bowel screen! About 60 per cent of those invited do the test, which means 40 per cent do not. They will not get the benefit of reduced bowel cancer mortality that has been demonstrated by bowel cancer screening programmes. It should be noted that there is evidence for the benefits of bowel cancer screening from aged 50, which is where it should be in New Zealand but unfortunately we do not have sufficient numbers of endoscopists to do the colonoscopy examinations that would be required if we screened from age 50 to 74.
If you are aged between 50 and 60 and have no symptoms and have not had a colonoscopy but want to be screened, you could discuss your situation with your GP. There are options of doing tests outside of the screening programme, but this may come at a significant cost.
What diet or lifestyle changes should we consider to prevent bowel cancer?
It is very difficult to prove that lifestyle changes made now will significantly reduce your risk, as it will take a long period of time (years to decades) before these lifestyle factors change your cancer risk. The younger you are, the more likely you are to benefit from these changes. But I would suggest eating significantly less than 500 grams of processed meat a week. Bacon and sausages should be a treat and not the norm. Have your five veg and two fruit per day, and natural fibre (eg oats, legumes, bran, whole grain bread etc.) Stop smoking and drink alcohol within safe limits. If you have a lot of fat around your tummy, you need to try to lose it. Exercise regularly! It might decrease your bowel cancer risk and reduce your chance of becoming diabetic or having a heart attack.
Don’t be prudish. See your GP quickly if you have any symptoms, and make sure you take up the invitation to have that bowel screening poo test.
Living with diabetes – one man's story
More than 250,000 people living in New Zealand have been diagnosed with diabetes and it’s estimated that there could be as many as 100,000 who are diabetic but unaware. We asked Aucklander Andrew Hill to share his experience - his candid account of living with Type 2 diabetes demonstrates there are the massive implications on quality of life for those affected and also their whanau. We would like to thank Andrew for telling his story as part of our Men’s Health Month Series and encourage anyone who is concerned they may be diabetic or pre-diabetic to contact their doctor. An early diagnosis means you can take steps to manage your health.
When Aucklander Andrew Hill was diagnosed with Type 2 diabetes five years ago, it was a huge shock - the 50-year-old former rugby professional says he was fairly active and wasn’t a big drinker.
Genetics and lifestyle played a part in the diagnosis, Andrew says.
Type 2 diabetes is a progressive disease and while it can sometimes be avoided by lifestyle changes, in Andrew’s case his illness is complicated by the fact his pancreas does not produce enough insulin. He also has a high level of triglycerides, the fats in our blood that are used to provide energy for the body and are measured as part of a cholesterol test, his mother was diabetic and he’s part-Māori. The factors left him predisposed to getting diabetes.
His lifestyle has contributed to the progression of his disease – Andrew went through a stressful divorce 10 years ago and admits he could have looked after himself better during that time.
It’s been a tough journey – the medications he takes to control his cholesterol levels and diabetes have damaged his kidney and liver. Diabetes has affected his vision and he’s had to contend with sores on his lower legs and pain in his feet caused by poor circulation, also a downside of the disease.
Andrew has completely changed his eating habits, shifting to a low-fat low-sugar food plan. It’s been a steep learning curve as even eating fresh fruit and vegetables can be complicated for diabetics. A banana, which most people would think is a healthy option, can spike his sugar levels.
It’s been difficult emotionally as well – Andrew finds it hard to constantly explain why he wears pressure bandages on his legs or why he can’t have a drink. “I’ve grown up in the sports community – rugby and beer go hand-in-hand.”
He also faces regular blood tests, ongoing medical reviews and takes medication daily.
Andrew would like to see more nutrition education in New Zealand, particularly for Māori and Pasifika youth – these communities are over-represented in statistics for diabetes, obesity and poor cardiovascular health.
“I wish I’d known how damaging sugar and even small amounts of alcohol can be on the human body. I would have eaten more green vegetables and fewer carbs such as pasta, rice, potatoes and white bread.”
Andrew started his rugby career at Wesley College before going on to play for North Harbour and Manawatu.
At school, he says, many of his team-mates were focused on bulking up to be better at the game. But they weren’t always taking a healthy approach. “There should be more focus on body composition than weight.”
Andrew believes the Government also has a role to play in reducing the incidence of Type 2.
“The Government spends millions of dollars providing health care for people with cardiovascular issues, obesity and diabetes. I wish some of that money could go to making healthy eating cheaper.
“It’s all very well telling people to eat salmon but not everyone can afford that twice a week.”
Andrew would like to see GST reduced on fruit and vegetables and he would like to see more big companies encouraged to manufacture food and drink products for diabetics.
He says although you often see sugar-free products advertised, if they contain some artificial sugars, they are not suitable for diabetics.
He and his partner Karen are trying their hand at growing their own vegetables this year – they’ve planted capsicum, lettuce, tomatoes and zucchini – to reduce their supermarket spend.
“Diabetes has changed by life. Sometimes I feel like I’m fighting a losing battle – you can’t reverse Type 2 diabetes. Once a diabetic always a diabetic.”
But by sticking to healthy eating and regular exercise, Andrew is doing everything he can to keep his disease under control.
Te Atatu Toasted founder Clare Robinson is passionate about supporting New Zealanders wellbeing by providing them with a healthy nourishing breakfast cereal and ensuring they understand the importance of eating well and exercising. OurHealthy Blend Muesli is low-sugar and low-fat, ensuring it’s a fantastic breakfast option for diabetics or anyone committed to improving their daily diet. Sign up for a monthly subscription – it’s one less thing to worry about.