A team of researchers led by Dr. Feixiong Cheng at the Cleveland Clinic developed a computational method for identifying FDA-approved drugs that might be effective against AD. The National Institute of Health’s (NIH) National Institute on Aging (NIA) supported the study. Results appeared in Nature Aging on December 6, 2021.

A news release from the NIH said the researchers began by identifying genes associated with AD pathology. Then they constructed a network of molecular interactions connecting these genes. They focused on the subset of genes associated with both amyloid plaques and tau tangles, instead of one or the other. They also constructed networks of drugs and their molecular targets for more than 1,600 FDA-approved drugs. Then they calculated the relationships between each drug’s targets and the AD network components.

In the release, written by Brian Doctrow, Ph.D., the team identified 66 drugs with the closest relationships to AD-associated genes. Many are already being tested in ongoing AD clinical trials, proving the soundness of the approach. After considering other factors, the top candidate was sildenafil, also known by the brand names Viagra and Revatio. Sildenafil is FDA-approved to treat erectile dysfunction and pulmonary hypertension.

Next, the team analyzed insurance claims data from more than 7 million Americans. They found that the people (mostly men) who took sildenafil were 69% less likely to develop AD over 6 years than those who did not take the drug. This association between sildenafil and AD held after adjusting for sex, age, and other diseases and conditions.

To understand how sildenafil might affect AD, the researchers grew neurons from stem cells derived from AD patients. Exposing the cells to sildenafil led to increased growth of neurites, which connect neurons to each other, and decreased tau phosphorylation, an early biomarker of AD.

Taken together, these results show an association between sildenafil use and reduced AD risk. But the researchers emphasize that they haven’t shown that sildenafil prevents or reverses AD. There may be other factors responsible for the association.

“Because our findings only establish an association between sildenafil use and reduced incidence of Alzheimer’s disease, we are now planning a mechanistic trial and a phase II randomized clinical trial to test causality and confirm sildenafil’s clinical benefits for Alzheimer’s patients,” Cheng explains.

“This is one of many efforts we are supporting to find existing drugs or available safe compounds for other conditions that would be good candidates for Alzheimer’s disease clinical trials,” says Dr. Jean Yuan, a program director at NIA. Repurposing existing drugs could save time and costs of bringing AD therapies to patients.

That’s according to Dr. Martin Miner, Regional Medical Director of Vault Health, a men’s telehealth company.

Miner has revealed seven important habits that most men over 30 are NOT currently doing to improve their health and should be:

Realizing that your body is communicating with you. Becoming acutely aware of your own physical and emotional feelings is something many men neglect to do, and it has a negative impact on their health as they age. Take command of your feelings and life–and learn to take actions that steer the ship the way you want to go.

Going to the doctor on a regular basis, even when you’re not sick. Seeing a doctor regularly can help the doctor find problems early or even before they start.

Rethinking your typical daily diet. The days of gorging without gaining weight are over. And as your metabolism slows, eating fewer calories can boost health. But you should also make sure to get adequate nutrients, vitamins, and fluids.

Exercising consistently (instead of intermittently). Regular exercise significantly lowers your risk of diseases, such as heart disease and cancer, and helps you retain your mobility longer. Exercise also lowers stress and improves sleep, skin and bone health, and mood.

Taking stress reduction seriously. The effects of stress on your body are vast, ranging from premature aging and wrinkles to a higher risk of heart disease. Being happy and keeping your stress down goes a long way in helping you live and age well. In addition, testosterone levels are reduced in response to stress according to studies.

Investing in your relationships. This is more crucial than ever coming off the heels of this pandemic, when many people have slipped into isolation. Studies show that meaningful relationships and a strong social network improve mental and physical well-being and longevity. If you don’t currently have an active social life, look for opportunities to reconnect with old friends or make new ones. Seek out like-minded others at work, church groups, volunteer activities, gyms, alumni groups, or any other group that corresponds to an interest of yours.

Aging gracefully isn’t about trying to look like a 20-something — it’s about living your best life and having the physical and mental health to enjoy it. Like a bottle of wine, you can get better with age with the right care, Miner says.

Ideally, you’ll have already been practicing healthy habits throughout your life. But even if you haven’t, it’s never too late to start taking proactive steps to maintain and even improve your health.

The natural aging process for men includes decreased testosterone, and physical activity levels decline with age, leading to declines in artery health and function. Testosterone replacement therapy is often used to combat the symptoms of decreasing testosterone levels, including low energy, reduced muscle mass and reduced vigor. In the absence of any new clinical indications, testosterone sales have increased 12-fold globally in the past decades.

“The global increase in testosterone use has been very large, particularly among middle-aged and older men who might see it as a restorative hormone to increase energy and vitality,” said study author Daniel J. Green, Ph.D., Winthrop Professor and cardiovascular exercise physiology researcher in the School of Human Sciences at The University of Western Australia in Perth, Australia. “However, previous studies are mixed as to whether replacement testosterone is beneficial or not, or whether it provides additional benefit over and above the effects of an exercise program.”

Green and colleagues evaluated men ages 50 to 70 years old, with no history of cardiovascular disease, higher than normal waist circumferences and testosterone levels that were in the low to normal range. The researchers also excluded current smokers, men currently on testosterone treatment or men on medications that would alter testosterone concentrations. At the beginning and end of the study, researchers measured artery function using a method that increases blood flow inside an artery. This assesses whether the inner lining of the artery is healthy and can help the artery to increase in size or dilate.

The 12-week study included 78 men randomized into four groups: 21 men received topical testosterone and completed a supervised exercise program including aerobic and strength exercises two to three times a week; 18 men received testosterone with no exercise; 20 men received a placebo and no exercise; and 19 men received a placebo with exercise. The exercise training was supervised in a research gymnasium at Fiona Stanley Hospital in Perth, and the program was overseen by an Accredited Exercise Physiologist (AEP).

The researchers found:

Testosterone treatment increased the levels of the hormone to above average levels in 62% of men in the groups that received the treatment.

Exercise training also increased testosterone level; however, the levels were highest among the men in the groups who received the testosterone supplement.

Artery function and health improved in the groups who received exercise training; but no improvement was found in those who received testosterone without exercise training.

Artery function in response to testing improved by 28% in the group who received exercise without testosterone, and by 19% in the group who received a combination of testosterone and exercise.

The researchers did not see changes in other tests that stimulated muscle cells in the middle of the artery wall, following exercise training, testosterone treatment or the combination of the two.

“The results of our study suggest that if you are a healthy but relatively inactive middle-aged or older man with increased abdominal girth, and you are worried about your risk of heart attack, stroke or diabetes, then an exercise program with some support and supervision can help to improve the function and health of your arteries,” Green said. “Testosterone therapy may have some benefits, for example in increasing muscle mass in the legs; however, we didn’t find any benefits in terms of artery function, which is a determinant of future cardiovascular risk.”

Green noted that the study’s small size is a limitation, and this research lays the foundation for larger studies that could lead to health recommendations for men.

For more information on heart issues, click here to visit the AHA website.

Because male breast cancer is rare, there is very limited information on how to treat men diagnosed with the disease. “In the absence of better information to guide us, we tend to treat men with breast cancer the same way we treat women,” says Tatiana M. Prowell, MD, breast cancer scientific liaison at the U.S. Food and Drug Administration (FDA).

“Men have historically been excluded from breast cancer trials. In the last few years, we’ve begun asking drug companies to allow men in clinical trials unless there is a valid scientific reason to exclude them,” Prowell says.

The response from companies, researchers, and patients has been very positive. Breast cancer awareness is growing, and now most breast cancer trials being designed include men. “For the first time, men can access investigational treatments in clinical trials and contribute to scientific advances and knowledge for others with this disease,” Prowell says.

Symptoms of Breast Cancer in Men

Each year, about 2,000 cases of male breast cancer are diagnosed in the United States, resulting in about 500 deaths, according to the National Cancer Institute. Although it can strike at any age, breast cancer is usually diagnosed in men ages 60 to 70.

Why does it often take so long to recognize the signs of breast cancer in men? One reason for the late-age (and later stage) diagnosis may be that men and their doctors don’t think of themselves as being at risk of breast cancer. “You’d think that because men have smaller breasts, they would get diagnosed at an earlier stage than women,” Prowell says. “In many men, though, diagnosis is actually delayed because men and their doctors aren’t expecting a breast lump to be cancer.”

Most men with breast cancer have painless lumps they can feel. The lumps can develop anywhere on the breast and often are underneath the nipple and areola complex – right in the center. Because men don’t have regular mammograms, their breast cancer may be discovered after a local injury, such as a fall or minor chest wall trauma, leads them to feel the breast area. “Men commonly attribute a breast lump to some sort of injury. The mass was already there, but they didn’t notice it until it got sore after they were bumped in the chest, for example,” Prowell explains.

Risk Factors of Breast Cancer

Men and women share some similar risk factors for breast cancer: high levels of estrogen exposure, a family history of the disease, and a history of radiation to the chest. Although all men have estrogen in their bodies, other factors like obesity, cirrhosis (liver disease) and Klinefelter’s syndrome (a genetic disorder) can increase estrogen levels. All are known risk factors for male breast cancer.

“In many men diagnosis is delayed because men and their doctors aren’t expecting a breast lump to be cancer.”

If a close relative – their mother, father, brother, sister, children – has breast cancer, men are also at slightly higher risk to develop the disease themselves. Men who have a BRCA mutation, a mutation or change in a gene that predisposes them to breast cancer, are at a greater risk. Although their chance of developing breast cancer is still low (only about 5 percent to 6 percent), men with a mutation in BRCA2 have a 100 times greater risk of developing breast cancer than men in the general population.

“In men and women, having a tumor with estrogen and progesterone hormone receptors is more common than not—but that appears to be even more true in men,” Prowell says.

Breast Cancer Treatments for Men

Treatment options for men are similar to women’s: mastectomy, which is surgery to remove the breast, or in some cases lumpectomy, radiation, chemotherapy, targeted therapies and hormone therapy. Hormonal drug treatments include aromatase inhibitors or tamoxifen, which lower estrogen levels in the bloodstream or prevent estrogen in the bloodstream from interacting with estrogen receptors on breast cancer cells.

For men with larger tumors or tumors that have spread outside of the breast, chemotherapy is often recommended in addition to hormonal treatment, just as it is for women. And men whose tumors are HER2 positive or have certain mutations in them are recommended to receive treatment with drugs that work against those targets, just as women are.

The FDA recently published a draft guidance, Male Breast Cancer: Developing Drugs for Treatment, to help facilitate drug development for men with breast cancer. The draft guidance recommends the inclusion of men in clinical trials of breast cancer drugs unless there is a scientific reason for their exclusion.

Genetic Counseling Is a Must for Men

All men with breast cancer should be referred for genetic counseling, Prowell advises.

That’s another difference from women, who are not automatically referred to a genetic counselor for genetic testing, such as for mutations in BRCA-1 or 2.

Even among men there are differences. African American men are more likely than white men to have advanced stage tumors at diagnosis and to develop triple-negative cancers. Their types of tumors are more likely to recur and have fewer treatment options.

People should tell their health care provider if any man in their family has had breast cancer, Prowell says. “Even if your grandfather is deceased, if he had breast cancer, that’s important. Because male breast cancer is so rare, seeing even one man in a family lineage raises concerns about hereditary breast cancer,” Prowell adds.

The men who could benefit from Jatenzo have low testosterone levels due to specific medical conditions, such as genetic disorders like Klinefelter syndrome or tumors that have damaged the pituitary gland. The agency emphasized that  Jatenzo shouldn’t be used to treat men with “age-related hypogonadism,” in which testosterone levels decline due to aging, even if these men have symptoms that appear to be related to low testosterone. Jatenzo’s benefits do not outweigh its risks for that use, the FDA said.

“Jatenzo’s oral route of administration provides an important addition to current treatment options available for men with certain hypogonadal conditions who up until now have most commonly been treated with testosterone products that are applied to the skin or injected,” said Hylton V. Joffe, M.D, M.M.Sc., director of the Division of Bone, Reproductive and Urologic Products in the FDA’s Center for Drug Evaluation and Research.

“But it’s important to emphasize that this drug should not, like other testosterone treatments, be used to treat older men with ‘age-related hypogonadism.’ The benefits of testosterone therapy, including Jatenzo, have not been established for this use, and Jatenzo’s effects on raising blood pressure can increase the risks of heart attack, stroke and cardiovascular death in this population.”

The efficacy of Jatenzo in battling some kinds of hypogonadism was demonstrated in a four-month clinical trial involving 166 men with hypogonadism. Study participants initially were given Jatenzo at a dose of 237 mg twice per day, and the dose was adjusted downward or upward to a maximum of 396 mg twice per day on the basis of testosterone levels. The result: eighty-seven percent of Jatenzo-treated men achieved an average testosterone level within the normal range.

Jatenzo contains a boxed warning on its labeling stating that the drug can cause blood pressure to rise, increasing the risk of heart attack, stroke and cardiovascular death. Health care providers should consider a patient’s individual heart disease risks and ensure that blood pressure is adequately controlled before prescribing Jatenzo; they should also periodically monitor patient blood pressure during treatment. Jatenzo is currently one of two testosterone products that have this boxed warning. The FDA is requiring all testosterone product manufacturers to conduct blood pressure post-marketing trials to more clearly address whether these products increase blood pressure.

The drug was tested in a four-month clinical trial.

Common side effects, occurring in more than 2 percent of patients in the Jatenzo clinical trial, included headache, an increase in hematocrit (red blood cell count), a decrease in high-density lipoprotein cholesterol (“good” cholesterol), high blood pressure and nausea. An increase in prostate specific antigen (PSA) was also observed. Patients should have their hematocrit, cholesterol and PSA monitored regularly to check for changes. Those with benign prostate hyperplasia should be monitored for worsening of symptoms.

The FDA granted the approval of Jatenzo to Clarus Therapeutics.

The study was published in the November 21, 1918 issue of Neurology®, the medical journal of the American Academy of Neurology.  Besides the leafy greens, the study subjects ate berry fruits, dark orange and red vegetables and drank orange juice.

“One of the most important factors in this study is that we were able to research and track such a large group of men over a 20-year period of time, allowing for very telling results,” said study author Changzheng Yuan, ScD, of Harvard T.H. Chan School of Public Health in Boston. “Our studies provide further evidence dietary choices can be important to maintain your brain health.”

The study looked at 27,842 men with an average age of 51 who were all health professionals. Participants filled out questionnaires about how many servings of fruits, vegetables and other foods they had each day at the beginning of the study and then every four years for 20 years. A serving of fruit is considered one cup of fruit or ½ cup of fruit juice. A serving of vegetables is considered one cup of raw vegetables or two cups of leafy greens.

Participants also took subjective tests of their thinking and memory skills at least four years before the end of the study, when they were an average age of 73. The test is designed to detect changes that people can notice in how well they are remembering things before those changes would be detected by objective cognitive tests. Changes in memory reported by the participants would be considered precursors to mild cognitive impairment. The six questions include “Do you have more trouble than usual remembering a short list of items, such as a shopping list?” and “Do you have more trouble than usual following a group conversation or a plot in a TV program due to your memory?” (Read our story, “Sleep and Memory: How They Work Together.”)

“Our studies provide further evidence dietary choices can be important to your brain health.”

A total of 55 percent of the participants had good thinking and memory skills, 38 percent had moderate skills, and 7 percent had poor thinking and memory skills.

The participants were divided into five groups based on their fruit and vegetable consumption. For vegetables, the highest group ate about six servings per day, compared to about two servings for the lowest group. For fruits, the top group ate about three servings per day, compared to half a serving for the bottom group.

The men who consumed the most vegetables were 34 percent less likely to develop poor thinking skills than the men who consumed the least amount of vegetables. A total of 6.6 percent of men in the top group developed poor cognitive function, compared to 7.9 percent of men in the bottom group.

The men who drank orange juice every day were 47 percent less likely to develop poor thinking skills than the men who drank less than one serving per month. This association was mainly observed for regular consumption of orange juice among the oldest men. A total of 6.9 percent of men who drank orange juice every day developed poor cognitive function, compared to 8.4 percent of men who drank orange juice less than once a month. This difference in risk was adjusted for age but not adjusted for other factors related to reported changes in memory.

The men who ate the most fruit each day were less likely to develop poor thinking skills, but that association was weakened after researchers adjusted for other dietary factors that could affect the results, such as consumption of vegetables, fruit juice, refined grains, legumes and dairy products.

The researchers also found that people who ate larger amounts of fruits and vegetables 20 years earlier were less likely to develop thinking and memory problems, whether or not they kept eating larger amounts of fruits and vegetables about six years before the memory test.

The study does not show that eating fruits and vegetables and drinking orange juice reduces memory loss; it only shows a relationship between them.

A limitation of the study was that participants’ memory and thinking skills were not tested at the beginning of the study to see how they changed over the course of the study. However, because all participants completed professional training, they can be assumed to have started with relatively high cognitive function in early adult life. In addition, the study participants were all male health professionals such as dentists, optometrists, and veterinarians. Thus, the results may not apply to women and other groups of men.

The findings were published in the fall issue of Retinal Cases.

“People live by the philosophy that if a little bit is good, a lot is better. This study shows how dangerous a large dose of a commonly used medication can be,” said lead investigator Richard Rosen, MD, Director of Retina Services at New York Eye and Ear Infirmary of Mount Sinai (NYEE). “People who depend on colored vision for their livelihood need to realize there could be a long-lasting impact of overindulging on this drug.”

Rosen and a team of investigators from NYEE based their study on a 31-year-old patient who arrived at an urgent care clinic complaining of red-tinted vision in both eyes that hadn’t gone away in two days. He reported that his symptoms began shortly after taking a dose of liquid sildenafil citrate that he purchased over the internet (sildenafil citrate can cause visual disturbances with normal dosage, but symptoms typically resolve within 24 hours). The patient told doctors he had consumed much more than the recommended 50mg dose, and that symptoms began shortly after ingestion. The patient was then diagnosed with persistent retinal toxicity linked to the high dose of medication damaging the outer retina. His tinted vision has not improved more than a year after his initial diagnosis, despite various treatments.

Mount Sinai researchers used state-of-the-art technology, including adaptive optics (AO) and optimal coherence tomography (OCT), to examine the patient’s retina for evidence of structural damage at the cellular level, something that had never been done before. AO is a sophisticated technology that allows clinicians to examine microscopic structures of the eye in living patients with extreme detail. OCT is an advanced imaging system that reveals the cross-sectional details of the retina layer by layer.

The high-tech imaging allowed investigators to see microscopic injury to the cones of the retina, the cells that are responsible for color vision. The damage was similar to that seen in animal models of hereditary retinal disease such as retinitis pigmentosa or cone-rod dystrophy.

“To actually see these types of structural changes was unexpected, but it explained the symptoms that the patient suffered from. While we know colored vision disturbance is a well-described side effect of this medication, we have never been able to visualize the structural effect of the drug on the retina until now,” said Dr. Rosen. “Our findings should help doctors become aware of potential cellular changes in patients who might use the drug excessively, so they can better educate patients about the risks of using too much.”

The findings, according to UT Southwestern researchers, indicate the importance of physicians’ checking for the problem.

Published in the journal Urology, the investigation called for a new routine part of male physicals, saying that general practitioners and urologists should have their patient perform a standing cough test. This involves a patient coughing while the doctor watches for any accidental urine release.

Stress urinary incontinence (SUI) occurs when physical activity or exertion – a cough, heavy lifting, exercise – causes the bladder to leak urine. About 13 million Americans suffer from some degree of incontinence, with women accounting for 85 percent of cases. However, some men who have had prostate cancer treatments involving surgery (prostatectomies) develop the condition.

“Male SUI is rare but is known to have significant negative psychosocial and emotional effects and represents a common reason for post-treatment anxiety and depression,” said Dr. Allen Morey, Professor of Urology at UT Southwestern and senior author of the study.

“Our goal is to spread the word that effective treatments exist for men with stress urinary incontinence, but also to facilitate an immediate and accurate diagnosis among stress urinary incontinence patients,” said Dr. Joceline Fuchs, Assistant Instructor of Urology and first author of the study.

There are simple and safe solutions – including minor surgeries that can either help boost a weakened sphincter muscle for patients with minimal leakage (the sling procedure) or replace the sphincter muscle altogether (installation of an artificial urinary sphincter) for more severe cases of leakage.

“Using new diagnostic techniques, we are now able to accurately diagnose and streamline treatment recommendations to resolve this bothersome problem for our patients,” said Morey, who holds the Distinguished Chair in Urology for Urologic Reconstruction, in Honor of Allen F. Morey, M.D., and the Paul C. Peters, M.D. Chair in Urology. “This study highlights an opportunity for improvement.”

According to a news release from UT Southwestern, during the study, researchers reviewed the cases of 572 men evaluated for anti-incontinence surgery in Dallas between 2007 and 2017. They found the median length of time the men had waited to seek treatment for their SUI was 32 months, with almost a third having waited more than five years. Patients in their 80s had waited a median of more than seven years.

Most recovery of urinary control occurs within the first 12 months after a prostatectomy, the study notes. Beyond the first year, improvement is unlikely. Care for such patients should include urologist-directed treatment plans that focus on non-cancer problems such as incontinence, researchers said.

Some treatment delay may also be tied to patient reluctance to undergo more surgery or due to limited geographic access to appropriate specialists, researchers said. However, patient satisfaction and quality of life improvement measures for those who do undergo anti-incontinence surgery are high, ranging from 73 to 90 percent, the news release said.

The American Cancer Society Prostate Cancer Survivorship Care Guidelines recommend screening for long-term functional effects such as urinary incontinence after prostate cancer treatment, the study points out, and those guidelines have been endorsed by the American Society of Clinical Oncology.

A release from Clevelan Clinic notes that results showed that more than 40 percent of biopsies could have been avoided in both the preliminary study (45.1 percent) and validation study (47 percent), suggesting that use of IsoPSA may substantially reduce the need for biopsy, and may thus lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.

The study, Prospective Validation of the IsoPSA Assay for Detection of High Grade Prostate Cancer, was conducted as a follow-up to early studies which demonstrated that IsoPSA, a structure-focused protein biomarker, may be an effective means of discriminating between high-grade prostate cancer (Gleason≥7) and low-grade/benign disease (Gleason=6).

The research team, led by Cleveland Clinic’s Eric Klein, M.D., conducted a multicenter validation trial and evaluated performance data with a new cohort, including cutoff parameters derived from a preliminary study, using the detection of cancer by biopsy as the endpoint.

The release quotes Dr. Klein, chair of Cleveland Clinic’s Glickman Urological & Kidney Institute, as saying, “To be clinically useful, a biomarker must be both tissue-specific and cancer-specific. While PSA is prostate-specific, it is not specific for prostate cancer, leading to diagnostic inaccuracy and too many unneeded biopsies. IsoPSA fulfills both the tissue- and cancer-specificity needed for a useful biomarker, and this validation study shows that it can more accurately detect high-grade cancer and reduce the rate of unneeded biopsies in patients at low risk of this disease.”

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The IsoPSA test was developed by Cleveland Diagnostics, a company co-founded by Cleveland Clinic, in which it has financial interest. Dr. Klein has no personal financial interest in the company. Mark Stovsky. M.D., a Cleveland Clinic urologist and co-author on the study, has a leadership position (Chief Medical Officer) and investment interest in Cleveland Diagnostics. In late 2017, Cleveland Diagnostics and Genomic Health announced an exclusive licensing agreement to develop and commercialize the IsoPSA test.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 52,000 employees are more than 3,600 full-time salaried physicians and researchers and 14,000 nurses, representing 140 medical specialties and subspecialties. Cleveland Clinic’s health system includes a 165-acre main campus near downtown Cleveland, 11 regional hospitals, more than 150 northern Ohio outpatient locations – including 18 full-service family health centers and three health and wellness centers – and locations in Weston, Fla.; Las Vegas, Nev.; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2017, there were 7.6 million outpatient visits, 229,000 hospital admissions and 207,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.

The researchers surveyed 630 young men ages 15-29 in Western Canada and found that the most strongly endorsed masculine value is selflessness. Ninety-one per cent of the men agreed that a man should help other people, and 80 per cent believed that a man should give back to the community. Openness also ranked highly–88 per cent said a man should be open to new ideas, new experiences, and new people–and so did health, with a majority of participants saying that men should be healthy or in good shape.

The findings were published in The Psychology of Men & Masculinity.

According to a news release from the university, more traditionally “male” values ranked lower on the scale, but were still valued by the majority of participants. Seventy-five per cent of the men said that a man should have physical strength, compared with those who said a man should have intellectual strength (87 per cent) or emotional strength (83 per cent). Autonomy also tracked lower with 78 per cent of the men agreeing that a man should be “independent.”

“Young Canadian men seem to be holding masculine values that are distinctly different from those of previous generations. These values may run counter to long-standing claims that young men are typically hedonistic, hypercompetitive, and that they risk or neglect their health,” said lead author John Oliffe, a nursing professor who leads the men’s health research program at UBC.

Nick Black, managing partner at Intensions Consulting and a study co-author, believes many young Canadian men are expanding their definition of masculinity to include values like openness and well-being.

“As a millennial myself, I can see these values reflected in the lives of men around me,” said Black. “They want to be both caring and strong, both open to others and self-sufficient, and they see no contradiction in these values.”

Oliffe says more research is needed to include other age groups and geographical locations, but adds that the current results could be useful for designing more effective men’s health-care programs.