How men can best protect themselves against the many health crises they face in midlife

With an average life expectancy at birth of 82.7 years, men in Hong Kong live long lives by global standards. But a long life is not a guarantee of a long healthspan. On almost every measurable health outcome, Hong Kong women are healthier than their male counterparts. There are several reasons for this. Men are generally more likely to put off seeking healthcare and ignore early warning signs until a condition advances to a critical stage. Men are also at a higher risk of cardiovascular diseases such as heart attacks and strokes, metabolic disorders such as type 2 diabetes, and developing mental health disorders, and are less likely to see a doctor over issues related to their sexual health. So how can men make sure their lives are not just long but healthy, too? Normalising the healthcare conversation Government campaigns such as those promoting Pap smears and mammograms have normalised conversations surrounding healthcare for women, and have conditioned them to undergo checks early and regularly. But this is not the case for men, who would benefit from regular health screenings and opportunities for discussions about general health. Hong Kong general practitioner Dr Geoffrey Yu Chi-hang advises men to undergo a health screening annually – or at least once every two to three years – to keep an eye on the “three highs”: blood pressure, glucose and cholesterol, which are all “major risk factors for stroke, heart failure and chronic kidney disease”. Screenings typically include simple blood tests that check kidney and liver function, and can flag any related problems before the onset of symptoms. A more detailed health analysis might include an electrocardiogram to check the heart. Heart disease is a big killer in men of Hong Kong, accounting for more than 4,200 deaths in 2023. Strokes, which can be fatal and often lower the sufferer’s quality of life, are largely driven by midlife cardiometabolic risks, many of which would be flagged through an ECG. The midlife metabolic crisis Many middle-aged Hong Kong men face a metabolic crisis. Carrying high visceral adiposity – deep belly fat – sets off a dangerous chain reaction that damages the heart and kidneys and affects blood sugar levels. This health burden, driven largely by poor diet and a lack of exercise, has steadily risen across the city over the last two decades. A population health survey in 2022 observed that 7.3 per cent of men aged 15 to 84 in Hong Kong lived with diabetes compared with just 3.6 per cent of women. Healthy ageing – meaning having a healthspan that matches one’s lifespan – is all about balance, says David Cox, author of The Age Code: The New Science of Food and How It Can Save Us. According to Cox, women are more likely to track the latest findings about diet and health, and perhaps as a result, are more likely to eat better. Men, and especially single men, Cox writes, have “a higher consumption of processed foods and much less diverse intake of fruits and vegetables, a dietary pattern which is linked to a much greater risk of higher blood pressure, higher cholesterol and more irregular meals”. This can set them up for poor metabolic health in midlife. Single men tend to eat more ready meals – often ultra-processed. These foods tend to contain additives, which Cox says can damage immune cells in the gut. This could be linked to the rise in colorectal cancers among young men. Colorectal cancers are among the most common cancers in Hong Kong; in 2023, they accounted for 14.4 per cent of all new cancer diagnoses in the city, and were more prevalent in men. Beware of the silent threat Men are less likely than women to see doctors about their sexual and reproductive health, but they should. Prostate cancer is among the biggest health threats facing men in Hong Kong today. A simple blood test can screen for this by measuring prostate-specific antigen (PSA) levels. Yu recommends starting testing at 40 years old if there’s a family history of prostate cancer, and at 50 if not. Yu warns that “early prostate cancer often has no symptoms”. When symptoms do appear, such as changes in urination – dribbling, weak flow or urgency, for example – men often dismiss them as part of getting older. That is why regular testing – every two years – is key. Seeing a doctor for such a test might also lend the opportunity for a discussion on erectile dysfunction – a distressing condition, but one that is common and treatable. Because vascular health directly affects erectile function, this talk can also serve as an early warning system for broader cardiovascular issues. The invisible mental burden Not only are Hong Kong men generally in poorer physical health than women, but the suicide rates among men are roughly double those for women. This disparity underscores a silent mental health epidemic that is frequently masked by social expectations. A 2024 survey by the Mental Health Association of Hong Kong suggests that nearly one in four men face a moderate to severe risk of mental health problems, notes Hong Kong psychologist Dino Wong Ching-kwong. “Alarmingly, about half of those at risk fall into the prime working age of 35 to 54. The primary triggers identified are deeply tied to the pressures of Hong Kong life, which include work, financial strain, health anxieties and family responsibilities,” Wong says. The survey also found that more than 60 per cent of men surveyed said they would not seek professional help for their mental health, which Wong puts down to “deeply ingrained gender stereotypes” and that asking for help is a “sign of weakness”. Wong urges all men to incorporate a regular mental health check into their routine by using the Depression, Anxiety and Stress Scale – commonly known as the Dass-21 – which can be found online here. “Just as a blood pressure cuff alerts you to hypertension before a stroke occurs, this scale catches elevated levels of stress, anxiety and depressive symptoms before they escalate into a clinical crisis.” Doctors’ healthy living tips Wong leads by example in living a healthy life, adhering to the six core pillars of lifestyle medicine: nutrition, physical activity, sleep, stress management, avoidance of risky substances and social connection. He schedules regular gatherings with friends, dedicates time to mindfulness to manage stress and does cardiovascular exercise in natural sunlight twice a week, which, he says, “boosts both physical endurance and mood”. Safeguarding the quality of restorative sleep is “a foundation for my overall resilience”, he says. Having a balanced diet and avoiding all “risky substances” also protect his long-term health. To support well-being, Yu urges people to find their passion. Engaging in an activity that you enjoy does more than relieve stress, he says. It can help manage blood pressure and cortisol levels, reducing the risk of heart disease. “Our physical health is closely linked to psychological well-being.” Yu recommends men follow three basic rules: eat well, sleep well and get regular exercise. “These are crucial not only for physical health – reducing risk for heart disease and stroke – but also in maintaining good mental health,” he says. Yu also urges men to seek help as soon as any health issue arises. “Problems won’t go away by ignoring them. That only worsens the issue.” Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.

How men can best protect themselves against the many health crises they face in midlife

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Ahead of Father’s Day, experts explain how men can lower the risk of heart attacks, diabetes, strokes and more for a long, healthy life

Normalising the healthcare conversation

Ahead of Father’s Day, experts explain how men can lower the risk of heart attacks, diabetes, strokes and more for a long, healthy life