A meat & potatoes man.

He likes meat and potatoes... and he avoids vegetables like the plague. You got a problem with that?

Yup. Heart disease, stroke, and cancer for starters. How many problems does it take for one man to change his diet?

Of course, even if men ate the healthiest diet possible, they'd still have a higher risk of some illnesses. For example, just being a man is considered a "risk factor" for heart disease. And men are more likely to be long-time smokers or heavy drinkers, which increases the risk of heart disease, stroke, and many cancers.

And most men--or women, for that matter--won't eat anywhere near the healthiest diet.

RISKY RED NUT

What's wrong with a meat-and-potatoes diet? First there's the meat itself--the burgers, steaks, hot dogs, and sausages.

Most people now know that burgers, etc., are one of the heart's worst enemies. Red meat--especially ground beef--is the largest source of artery-clogging saturated fat in the average American's diet.

But fewer people know that red meat is linked to a higher risk of colon and prostate cancers. After lung, they're the two cancers that kill the most men.

"Men who eat red meat as a main dish five or more times a week have four times the risk of colon cancer of men who eat red meat less than once a month," says Edward Giovannucci, an epidemiologist at Harvard Medical School. Heavy red-meat eaters are also more than twice as likely to get prostate cancer.

Giovannucci is talking about results from the Health Professionals Follow-up Study, which has tracked more than 50,000 men--including dentists, veterinarians, and pharmacists--who were 40 to 75 years old when the study began in 1986.[1,2]

"It's unclear whether eating red meat once a week is any worse than never eating it," he adds. "But certainly, once a day should be avoided. "

Other studies have also zeroed in on meat-and-potatoes-men.[3] "We identified a pattern in which people eat lots of meat and potatoes and little of other foods," says epidemiologist James Marshall of the State University of New York at Buffalo. That pattern was more closely tied to their risk of colon cancer than was their fat intake.

What makes red meat so risky? It could be the fat, or that carcinogens are created when meat is cooked. But what meat-eaters don't eat also plays a role.

TOO FEW VEGETABLES

"Part of what's bad about red meat is the fruits, vegetables, and whole grains it displaces," says Giovannucci.

(Yes, potatoes are a vegetable. But for meat-and-potato-eaters, potatoes often means french fries with as much artery-clogging fat as the burger they come with. And the National Cancer Institute doesn't count fried potatoes when it urges people to eat five to nine servings of fruits and vegetables every day.)

What can men expect for every three servings of fruits or vegetables they eat every day? A 22 percent lower risk of stroke, according to the Framingham Study, which followed 832 middle-aged men for 20 years.[4]

And, says Giovannucci, "we now have evidence that a high fruit and vegetable intake is beneficial for preventing most cancers." Among them:

* Lung & other smoking-related cancers. Not smoking is obviously the best way to curb the number-one cancer killer of men (and women). But eating fruits and vegetables may lower the risk of lung cancer in smokers from 20 times the risk of non-smokers to "only" ten times the risk. It may also protect against oral, throat, pancreas, and bladder cancers, all of which are more common in smokers.5

* Stomach & esophageal cancers. The fastest-rising malignancy in the U.S. is cancer of the lower esophagus. Lower-stomach cancer is also on the upswing ... and white men are the leading victims of both. The latest clues to the mystery: at least for the lower esophagus, obesity is a culprit, while fruits and vegetables are protectors.[6]

* Colon cancer. The evidence that fruits and vegetables protect against colon cancer is so strong that the National Cancer Institute's Polyp Prevention Trial is now testing whether five to eight servings a day (along with whole grains and a low-fat diet) can prevent pre-cancerous polyps in the colon.

In fact, says Buffalo's James Marshall, getting people to eat enough fruits and vegetables may also automatically cut the meat and fat they eat. "If you stuff yourself with fruits and vegetables, the rest will take care of itself," he says.

"The only thing you have to be careful about is that you don't go overboard with salad dressing or drench the vegetables in butter or deep-fry them."

What's in fruits, vegetables, and grains that might protect against cancer? It could be lots of things. "It may be that carotenes are good for one type of cancer, [the B-vitamin] folic acid is good for another, and fiber is good for others," says Giovannucci.

"I don't think we'll find one magic bullet. But it's clear that a dietary pattern rich in fruits, vegetables, and whole grains is good for a lot of cancers and for heart disease."

COUNT 'EM UP

So, how are men doing? Lousy.

According to a 1991 survey by the National Cancer Institute (NCI), men average three servings of fruits and vegetables a day. "Women are doing a touch better," says the NCI's Amy Subar. They average 3.7 servings.

The biggest difference: Women eat whole fruit more often (seven times a week) than men (four times a week). They consume fruit juices and vegetables equally often.

But men do far worse when you consider that the NCI's advice isn't to eat just five, but five to nine, servings of fruits and vegetables every day.

"Men should be at the top end of the range because they eat more food," says the NCI's Susan Krebs-Smith. "That means five servings of vegetables and four servings of fruit. Most men are not eating that level at all."

[1] Journal of the National Cancer Institute 85: 1571, 1993. [2] Cancer Research 54: 2390, 1994. [3] Nutrition and Cancer 18:265, 1992. [4] Journal of the American Medical Association 273: 1113, 1995. [5] Cancer Causes and Control 2: 325,1991. [6] Journal of the National Cancer Institute 87: 104, 1995.

RELATED ARTICLE: What to Eat

Diet can cut the risk of four of the ten leading causes of death (and quite a few minor ones, too), if you:

* Cut back on fats, especially saturated and trans fats. That means less red meat, cheese, whole and 2% milk, chicken and turkey with skin, and foods made with butter or palm, coconut, or partially hydrogenated oils. If you eat red meat, make it no more than once a week. That should lower your risk of heart disease and prostate and colon cancers.

* Load up on beans and (preferably whole-grain) pasta, bread, rice, and breakfast cereals. You'll reduce your risk of heart disease and cancer.

* Eat five to nine servings of fruits and vegetables every day--the more the better. The average American man barely manages to eat three. You'll be lowering your risk of colon, lung, stomach, prostate, pancreatic, oral, laryngeal, bladder, and esophageal cancers.

* Cut your sodium to no more than about 2,400 mg a day, to lower your risk of high blood pressure.

* Talk to your doctor about taking aspirin to reduce your risk of heart disease and (possibly) colon cancer. And if you've already had a heart attack, transient ischemic attack, or non-hemorrhagic stroke, aspirin could reduce your risk of having another.

* If you drink, limit yourself to two drinks a day or less. If you don't drink, don't start. There are lots of other--less dangerous--ways to lower your risk of heart disease.

* Shoot for an optimal body weight. Your best bet is to stick to this table, which was published by the Metropolitan Life Insurance Company in 1959. Later weight tables got it wrong when they said that it's okay to be heavier: Height Weight (lbs.) (without shoes) (without clothes)

Women Men 5'0" 103-115 -- 5'1" 106-118 111-122 5'2" 109-122 114-126 5'3" 112-126 117-129 5'4" 116-131 120-132 5'5" 120-135 123-136 5'6" 124-139 127-140 5'7" 128-143 131-145 5'8" 132-147 135-149 5'9" 136-151 139-153 5'10" 140-155 143-158 5'11" - 147-163 6'0" - 151-168 6'1" - 155-173 6'2" - 160-178 6'3" - 165-183 Source: J. Am. Med. Assoc. 257:353, 1987.