What's gender got to do with it? John L. Wilson Jr., M.D. points out gender's role in health as we age and offers up lifestyle interventions that may help us reverse the course of our chromosomes.

From conception to old age, gender's influence in determining health and longevity flies in the face of any notion of equality. In a face-off of the survival of the fittest, even though men are stronger, faster, taller and leaner than women, the vulnerability of males from conception to senior years ends up challenging conventional wisdom of just which is the "weaker sex."

Even though an estimated 115 males are conceived for every 100 females around the globe, approximately 105 males are born for every 100 females due to increased fetal demise of males. Although outnumbered at birth, females become a majority of the population in their mid-twenties, increasing eventually to 85 percent of the population by age 100. Statistics in industrialized nations in Europe and North America now reveal a decline in male birth rates, a decline linked by some scientists to endocrine-disrupting, or "gender-bender," toxins from industrial contaminants that seem to be preferentially harder on the Y chromosome.

In an attempt to explain these and other gender differences, medical experts point to men's higher testosterone levels, which are associated biologically with higher "bad" (LDL) and lower "good" (HDL) cholesterol levels; higher LDL levels and lower HDL levels are linked to increased risk of heart disease and strokes and also with risky, competitive and aggressive behaviors.

Male vulnerability that starts in the womb is evident in life expectancy, as women are expected to outlive men by up to 10 years worldwide (currently 79.8 for women and 74.4 for men in the U.S.). Men suffer more fatal diseases, such as heart disease and cancer, while women live longer with less rapidly fatal health problems, like osteoporosis and autoimmune disorders. However, the longevity gap is narrowing in western nations--a change theorized to be related to women adopting riskier behaviors formerly characteristic of men.

Eighty percent of osteoporosis sufferers are women, 80 percent of gout sufferers are men, and 83 percent of thyroid disease sufferers are women.

Other examples of the influence of gender in health throughout life, and interventions that can possibly counter gender's influence, include:

Autism: An estimated 80 percent of children diagnosed with autism or Autistic Spectrum Disorder (ASD) are boys. Autism is a complex developmental disorder characterized by impaired communication and social skills plus narrow, repetitive, inflexible attention, behaviors and interests. In 2007, the Centers for Disease Control (CDC) reported that one in every 150 children is currently diagnosed with autism. The diagnosis of autism is made by rating behaviors, including seeming disconnection from others, self-stimulation behaviors (flapping, rocking), lack of speech, and lack of resiliency to change in routine.

Change the course: Though the diagnosis of autism is based on behavioral indexes, it can also be helped by biological interventions. In addition to vitamin B12's ability to assist detoxification for many autistic children, digestive and genetic abnormalities common in autistics can result in the proteins gluten in wheat and casein in dairy products forming morphine-like, mind-numbing compounds (gluteomorphine and casomorphine) that perpetuate autistic symptoms. Avoidance of wheat and dairy can be essential for some autistics to improve functioning.

Gallbladder Disease: The "five f's" used by many physicians to describe people most at risk for developing gallbladder disease (including inflammation, stones and obstruction) are "fair, fat, female, forty and fertile." Over a lifetime 70 percent of an estimated 20 million Americans who have gallbladder disease are women. Additional risk factors include the use of birth control pills, estrogen prescribed without monitoring blood levels of estrogen and its metabolites, and pregnancy. Women on weight loss diets, especially those who cyclically "yo-yo" or "crash" diet, are at increased risk for developing gallstones.

Change the course: In addition to avoiding a diet rich in fat, sugar and refined foods, eating more whole foods with a focus on nutrient-dense, brightly colored vegetables is recommended. As reported in the American Journal of Gastroenterology, magnesium deficiency increases the risk of gallstone formation by 30 percent. Taking magnesium supplements can slow gallstone formation, as can fish oil supplementation and the amino acid taurine. Eating foods to which one is allergic can also cause swelling of the gallbladder ducts, increasing the likelihood of a stone becoming lodged in a duct. Though any food can be a culprit, the most commonly suspect foods include eggs, pork, onions, citrus fruit, corn and nuts.

Heart Disease: Gender differences in how heart disease symptoms present are becoming more apparent following decades of research primarily conducted on men. Women have a lower risk of heart disease than men early in life, but these risks are the same at the end of life following menopause. Unlike the classic symptoms of a crushing chest pain that radiates down the arm and sweating commonly experienced by men having heart attacks, women may have a very different symptomatic presentation, including unusual fatigue, sleep disturbance, shortness of breath, indigestion, anxiety and arm heaviness or weakness. These more subtle symptoms risk being misinterpreted as "stress." Rather than the localized point of obstruction along the course of coronary arteries commonly seen in men, women are more apt to have plaque evenly distributed along their arteries, a type of obstruction not as readily apparent on tests that traditionally diagnose coronary artery obstruction.

Change the course: In addition to the lifestyle modifications (smoking cessation, exercise, weight control and a healthful diet) recommended to reduce heart disease risk, limiting dietary sugar is encouraged as a strategy to limit insulin production. Chronically high insulin levels result in the storage rather than burning of body fat and in the thickening of the lining of arteries (endothelium), which can set the stage for heart disease. Formation of blockages in coronary arteries is now known to be due to an inflammatory process and can be lessened by eating oily fish (e.g., salmon, herring, mackerel and sardines) and fish oil supplementation.

Change of Life Menopause, women's change of life that occurs when the ovaries naturally decrease their production of estrogens and progesterone, is far better researched than its male equivalent, andropause, that results from decreased testicular testosterone production. Menopause and andropause differ in that women relatively abruptly become unable to bear children after their menstrual periods cease, while men experience a far more gradual decline of testosterone production, allowing them to father children into the later decades of life. Men are far less apt to seek medical remedies for their decline in sex hormones and its associated problems than women. But, both men and women are at risk for developing unhealthy ratios of sex hormones that result in estrogen excess or imbalances.

Change the course: Cruciferous vegetables (broccoli, cauliflower, kale, cabbage, mustard greens, brussel sprouts and collards) contain a chemical called indole-3-carbinol (I3C) that is converted in the body to di-indolemethane (DIM). DIM plays an important role in reducing the conversion of men's testosterone to estrogen later in life and also stimulates healthy estrogen metabolism in women. While "good" estrogen metabolites promote vitality and health and protect the heart and brain, "bad" estrogen metabolites promote obesity and cancer. Some individuals may also benefit from an assessment of their hormonal status by a physician trained to assess and treat health problems associated with the change of life.

Gender aside, most health risks are modifiable by implementing lifestyle choices known to support good health. Applying simple lifestyle strategies, in particular diet strategies, that support health and avoidance of chemical toxins (e.g., smoking, pesticides, and industrial stack emissions) can go a long way to foster health throughout all the ages of life.

Sources: "Gluten, Milk Proteins and Autism: Dietary Intervention Effects on Behavior and Peptide Secretion" by K.L. Reicbelt, J. Ekrem and H. Scott, Journal of Applied Nutrition, 1990; U.S. National Center for Health Statistics, Vital Statistics of the United States, annual, and National Vital Statistics Reports (NVSR); "Long-Term Effect of Magnesium Consumption on the Risk of Symptomatic Gallstone Disease Among Men" by C.J. Tsai, American Journal of Gastroenterol, 2008; "Changes in Levels of Urinary Estrogen Metabolites After Oral Indole-3-Carbinol Treatment in Humans" by J.J. Michnovicz, Journal of the National Cancer Institute, 1997

John L. Wilson Jr., M.D., integrates 29 years of experience in mainstream and alternative medicine into his outpatient practice at Great Smokies Medical Center of Asheville. He can be contacted through Great Smokies' website at www.gsmcweb.com.