Low T, ED and Big Bellies

Dr. Jodi Nishida
Hawai‘i Herald Columnist

Low testosterone, erectile dysfunction and belly fat. This month’s article is about men’s health. Before you turn the page, ladies, you might want to read on as some of these may affect the men in your life. A few decades ago, the term “men’s health” was confined to heart attacks, quitting smoking and receding hairlines. In recent years there’s been an explosion of clinics designed just for men. You’ve heard the radio ads and seen the commercials. These clinics target the same things: low testosterone, weight loss, hair restoration and erectile dysfunction. They promote testosterone injections and creams, growth hormone, vitamin B12 injections, pills, etc. When and how did these conditions become so prevalent in men? Read on.

Low T (reported) affects over 40% of men in the U.S. ages 45 years and older, and it is believed that many more cases are unreported. The symptoms of low T include:

• Loss of libido

• Erectile dysfunction

• Increased belly and visceral fat

• Depression – mild to severe

• Lack of motivation

• Decreased cognitive abilities (focus, concentration, memory)

• Low energy, fatigue

• Decreased bone mass

• Decreased muscle mass

• Impaired sperm production

Do any of these sound like you? Many people feel these are a function of normal aging and are “inevitable.” I’m here to tell you that they’re largely a function of diet. Before I start drawing connections between points in time, let’s explore how testosterone is made in men.

Testosterone is a steroid hormone. When testosterone levels are low, the hypothalamus and pituitary gland in the brain signal the Leydig cells in testicles to make more. Leydig cells convert cholesterol into testosterone. Over half of the cholesterol needed for this process comes from food that has been digested and broken down in the small intestine and liver. The reason I point this out is that gut health and liver health are extremely important in “cholesterol homeostasis” and ultimately in testosterone production in men. Diet, gut health, liver health, exercise, and adequate sleep are key to testosterone production in men.

Testosterone levels started noticeably declining in men of all ages in the mid-80s. The timing of this coincides with the 1980 U.S. Dietary Guidelines, which limited fat. As the fear of fat took over and low-fat food items appeared on our store shelves, high sugar foods appeared. The words “low-fat” and “high sugar” become a two-fold problem for men. 

  1. Sugar wrecks your gut lining and it must be emphasized here that carbohydrates (rice, bread, noodles, potatoes, beans, grains) turn into sugar. So it’s not just obvious sources like candy, soda, ice cream, muffins and shave ice. It’s also plate lunches, sandwiches, saimin, ramen, and French fries! We have well over 750 patients who have come to us with a variety of gut issues, which were 80-100% resolved by eliminating carbohydrates and sugar. 
  2. Low-fat eating doesn’t provide the cholesterol that’s needed to make hormones. There is so much confusion about good fat versus bad fat so let’s quickly revisit. The type of fat that’s needed to provide cholesterol comes from high quality dairy products like butter from grass-fed cows and cheese from small, organic farms or other countries. A far stretch from margarine and those cheese “singles” we all put on our bologna sandwich. Healthy fat also comes from lean cuts of red meat, pork, and ground beef as well as eggs, fish and shellfish. Please notice the types of protein listed. Spam, hot dog, and Vienna sausage did not make that list. Unhealthy fats are trans fats found in snacks, fast food, fried food, and baked goods. By lowering sugar and eating healthy fats, the basic building block for testosterone production can be easily provided. It’s simply a supply issue! Just like cars need oil to run smoothly, men need healthy fats to make testosterone.

Another huge contributor to the development of low T was the explosion of soy products. Did you know that the U.S. is the world’s leading soybean producer utilizing over 90 million acres of land for soy crops? Did you know that 90% of our cooking oil comes from soy? To be clear, I’m not talking about edamame, which is bright green and tender. I’m talking about mature soybeans that are brown, hard and dry. Soy has made its way into all animal feed, fast food, breaded foods, bread, cereal, crackers, vegan food, plant-based food, vegetarian food, burgers, ground meat products, hot dogs, cold cuts, sauces, marinades, imitation crab, imitation bacon, chips, baked goods, baking mixes, beverage mixes like hot chocolate, cooking sprays, frozen desserts, margarine, seasonings, spices, snack food, soups, broths, pasta, spreads, dips, mayonnaise, peanut butter, soaps, shampoos, lotions, personal hygiene products, fragrances, and candles just to name a few. Then there’s shoyu and the plethora of soy chai lattes or coffee drinks with soy milk that you hear everyone ordering. What men need to understand is that soy has an “estrogenic” effect in them. Think of estrogen as an anti-testosterone compound that strongly interferes with the testosterone assembly line. When you are unknowingly consuming an estrogenic compound every day all day in the commonly eaten foods and the personal hygiene products named above, the accumulation over time has detrimental effects to one’s testosterone levels. 

So let’s sum this up: Combining a low-fat/high-sugar diet with a high-soy (unknowingly) diet equals the recipe for low T. Again, I’m not talking about the occasional tofu dish or edamame pupu. I’m talking about what’s hidden in today’s food.

Enough with the doom and gloom. Men do have it easier in turning their health around because it takes less time and effort than women. Eliminate soda from your diet and you guys drop 30 pounds! It’s so unfair! That’s thanks to testosterone and your natural lack of estrogen and progesterone. 

If you suffer from any of the symptoms of low T, your first step should be to change your diet. Reduce carbohydrates, sugar, processed foods and fast food. Eat lean cuts of meat, eggs, fish and high quality dairy. Look through the above list of soy-containing foods and products and reduce them greatly in your daily routine. 

Second, exercise and get adequate sleep. You don’t need to lift heavy weights. Moderate weights at high reps with 20-30 minutes of cardio three to four times a week is perfect. Shoot for seven hours of sleep per night. Seven hours is the magic number and eight is even better. Whether you’re male or female, the above tips will make giant improvements in your hormonal balance, virility and fertility. If you start to notice that you have more energy, you know you’re well on your way.

Dr. Nishida is a Doctor of Pharmacy and accredited Metabolic Healthcare Practitioner who’s been in healthcare for over 25 years. After experiencing the ketogenic lifestyle’s effect on her own autoimmune condition, she decided to build a keto-based medical practice so others could benefit from it too. Over the last few years, she’s helped almost a thousand patients realize the benefits of clean, medically guided keto.

With certifications in ketogenic nutrition, cardiovascular disease management, pharmacogenomics, and medication management, she works closely with each and every patient to tailor keto to their medications, medical conditions, lifestyle and socioeconomic situation. Dr. Nishida is also in training for processed food addiction recovery. To learn more, or to contact Dr. Nishida, visit her website at theketoprescription.com.

The content of this column is not meant to be medical advice. Please consult your doctor before starting any diet or lifestyle change and understand that there is no blanket approach to keto. Keto should be tailored to each individual through the guidance of a trained professional.


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