The New York Times published an article by Nicholas Bakalar titled, “Boxers or briefs, It may depend on your fertility goals” which reported that men who wore looser fitting underwear produced more sperm and better quality swimmers than those men who wore tight briefs.  I think this makes complete sense, as the whole reason why nature has designed men’s genitalia to extend outside of the body is because sperm cannot survive in high temperatures, whereas ova (eggs) in woman can tolerate higher temperatures.

Here are some additional advice for men considering becoming fathers:

• Eat organic foods, especially when with fruits and vegetables that you will be eating the skin, have broad leaves or those that grow underground.  Typically organic produce is grown without pesticides.  If you think about it, pesticides are meant to kill small, rapidly growing insects and worms.  Guess what?  Sperm have very similar qualities.  Ingesting high amounts of pesticides could certainly reduce sperm reproduction.  Fruits and vegetables where you have to peel a thick skin (bananas, oranges, grapefruit, pineapple, pumpkin, etc.) may not always need to be organic as the thick rinds make it less likely for the pesticides to penetrate inside.
• Avoid crossing your legs.  For the same reason that tight underwear reduces sperm count by raising the temperature of the testicles, crossing your legs achieves a similar result.
• Avoid uninterrupted sitting.  Have you ever sat in a chair for a long time and started feeling warm in the pelvis?  Sitting in chairs, particularly in upholstery that doesn’t breathe such as leather, plastic, or vinyl can increase the temperature of male genitalia.  Stand up and stretch every so often.  Change your office chair to a mesh chair.  You can also purchase a small fan to place under your desk to promote air circulation.
• Avoid sitting in hot tubs or steam rooms.  These are known sperm killers as the temperatures can be as high as 110 degrees Fahrenheit, far too high for sperm to survive at long periods of time.
• If you smoke, stop smoking!  There are so many reasons to not smoke!
• If you drink alcohol regularly, drink in moderation.  This means no more than 2 drinks in 24 hours for men. (1 drink= 1 shot of liquor OR 1 bottle of beer OR 1 glass of wine)
• Increase your water intake.  Dehydration is not good for any organs in the body.
• Get regular exercise.  When you exercise, your heart pumps blood to all parts of the body including your legs, brain, and your reproductive organs.  In particular, I recommend “male Kegel exercises” which are designed specifically to strengthen the muscles down there.  Imagine exercise as a way to “flush out” old blood and bringing oxygen to those areas.
• Reduce stress.  Try meditating even 10 minutes a day. Don’t know how?  Here is a post on how to do it.
• Get adequate and proper sleep.  While we are asleep, our body repairs itself and relaxes.
• Eat shellfish or take a multivitamin.  Sperm need certain trace minerals to survive and grow.  One of these is zinc, which is naturally found in shellfish.  I believe the old wive’s tale that oysters stimulate libido is likely stemmed from this.  Be careful that the seafood you eat doesn’t contain too much mercury.  Find out more about seafood and mercury here.

I’m seeing many people are suffering from gas pains.  We are eating way too quickly (often inhaling food), not drinking enough fluids with our food, and drinking gassy liquids such as sodas and seltzers.  These can all cause gas to be trapped in our stomachs and intestines.  When this happens, we can feel uncomfortable abdominal or even chest pains!   The intestines and stomach are adjacent to our diaphragm and are very close to the heart and lungs.  Many times a week, someone will come into my office thinking they are having a heart attack, but after taking antacids and gas-relieving medications they feel immediately better.  I think part of the problem is that we are afraid to let go of our gas as it is not usually socially acceptable to pass gas from below or burp/belch in public.  As a result, we keep it all inside and it build until we have severe pain or discomfort.

Here are some tips I recommend to help you prevent/release gas:

• Eat more slowly- when we eat fast, we will swallow extra air with our food, eating slowly allows for less air.
• Avoid fizzy beverages- sodas, beer, seltzers, and champagne are extremely bloating.
• Avoid drinking beverages with a straw- drinking with a straw makes us ingest more gas than drinking from a glass
• Lie down and pull your knees up to your chest and hold them with your hands.  You can also rock from side to side on your back while in this position.  Ever wonder why many people pass gas in a yoga class?
• Take Gas-X tablets with your meals.  This is a pretty harmless medication (which never gets absorbed into your bloodstream, stays only in your intestines) which will effectively reduce gas.  I find this medication very helpful when I’m drinking/eating foods which I know will be gas forming such as beans, cauliflower, broccoli, and beer.
• Go to the bathroom when you feel gas is building and burp/pass gas from below.  I usually go into a stall and sit on the toilet (not to have a bowel movement).
• Identify foods which cause you to produce more gas.  Many are have been well-studied and called FODMAP foods.
• Avoid artificial sweeteners (in coffee, sugar free gum, sodas, etc.)- while they may make your food taste sweeter, they are notorious for causing gas and bloating and even diarrhea in large amounts!
• Drink plenty of water when you  eat.  Water helps you to digest food and pass food along your digestive tract.  I always tell people to take a sip of water in between every few bites of food.

There are several foods that you can easily overeat.  I recommend that if you do indulge in them, to be mindful of your portion size.  I recommend sharing them with friends, putting them in smaller size containers, or just avoiding them completely.  While I am not a proponent of wasting food, given some of the giant portions that food sometimes comes in, it may be a better solution than to ingest calories you may find it difficult to burn off (or may never burn off).

• Movie popcorn- these often come in ridiculously huge tubs and we unconsciously shovel handfuls into our mouths since we are distracted by watching the movie.  It’s very easy to consume 500+ calories in one sitting (one whole day’s worth of calories for the average person should be no more than 2000 calories).  Get the smallest size, share with a friend, or ask for an empty drink cup so you can pour the popcorn into a smaller container.  Another option at some theaters is kid’s size popcorn bags.
• Watermelon- it’s so delicious especially during the summer.  However, each slice can have in excess of 100 calories.  Try to limit it to one slice.  Watermelon is one of a few fruits that can be very high in sugar and calories.
• Nuts- they are a part of the Mediterranean Diet and are great for raising your HDL (good cholesterol), however, they often come in tubs which make it too easy to grab many handfuls.  Nuts are extremely high in calories.  A proper portion size of nuts is one palmful or approximately 12 nuts.  If you do buy nuts, scoop them out into small dishes.  I have a set of sauce dishes approximately 2 inches in diameter which almost always yields 12 nuts, and I do not refill the dish after I finish them.  Another option is to eat pistachios or peanuts in the shell as it takes much longer to eat.
• Chips- we often reach into the bag unconsciously until it is empty!  I would really try to avoid all chips, personally, I find carrots and hummus (or fat free salad dressing) to be much more satisfying.  As an alternative, I recommend purchasing small “snack bags” and portioning them out into single servings.
• High calorie beverages- these include juices, sodas, and alcoholic drinks.  Because they are liquids, we can ingest many of them in a short amount of time.  Much of the current obesity epidemic is from these sugary, high calorie drinks.  If you must have juice, dilute it with seltzer water or water (about 50/50).  You will still get the taste but half the calories. Try making your own fruit-infused water.
• Unwrapped chocolates- you get to a party and there is a bowl of brightly colored candy coated chocolates, you find yourself grabbing handfuls at a time and shoveling them into you mouth.  Sound familiar?  Opt instead for chocolates that are individually wrapped in “small sizes” instead.
• Peanut butter- this is a very high calorie food.  Many times, when medical missions go to countries where people are starving, they will often bring peanut butter to help people gain weight and provide sustenance.  Limit your intake of this high fat food by spreading a very thin layer on your food.  Oddly enough, jelly or fruit jam is less in calories and fat and would be a better choice for your sandwich or bagel topping.
• Giant coffee drinks- the ubiquitous coffee chain (whose symbol is a mermaid) sells sugary creamy coffee drinks laden with sugars and fat.  They come in HUGE sizes which can ruin your diet in an instant.  If you must get one of these, get the smallest size and ask for a separate cup so you can share it with a friend.
• Dried fruits- every try to eat 10 fresh plums in 2 minutes?  It would pretty much be impossible unless you were a champion food competition eater.  However, could you eat 10 dried prunes in that same time?  Most likely so.  They have the same calories!  Prunes are essentially plums that are dehydrated (water is removed).  I always recommend fresh fruits as opposed to dried fruits whenever possible.  I do like dried fruits when I’m traveling and may not have access to fresh fruits or if they would be too heavy to carry (while hiking), but I portion them out into small plastic snack bags. When eating dried fruits, try to drink extra water to allow them to rehydrate in your stomach, making it easier to digest.

There are some things in my day to day life that I find to be very helpful and keep me healthy.  Here are some of them and why they are favorite things, click on the hyperlinks for quick purchase through Amazon:

• Insoles for shoes.  We are on our feet all day, if your shoes are not adequately supporting your weight, your feet and knees can become overstressed leading to fatigue and pain.  Unfortunately, I have found that many shoe manufacturers have been skimping on quality of materials used in the soles.  Adding extra support with gel or foam insoles can greatly improve the comfort of your shoes.
• Antibacterial wipes.  I don’t travel anywhere without these.  Bacteria and viruses are spread easily when objects are touched by multiple people.  When do you think that airplane tray table, restaurant menu, or subway pole was last cleaned?  Likely not in the last few months.
• Large water bottle.  Hydration is so important.  When you have a large water bottle, you will likely drink more water.
• Facial wash.  During the day, our face can accumulate oils, dirt and pollen which can cause acne, eyelid swelling (stye),  and irritation.  Water alone rarely removes these adequately.  A facial wash keeps your skin fresh and clean.
• Aquaphor ointment.  For minor skin irritation, dryness and itching, Aquaphor is a must.  People suffering from eczema and psoriasis should always have this nearby as moisturizing can keep these conditions from getting worse.  I keep a tube in every drawer in every room so I can get immediate relief.
• Natural tears.  Most of us are suffering from dry eyes either from allergies or chronically looking at computer screens/tablets.  These individually packaged drops are close in chemical composition to our own tears and keep your eyes moist.  I use them every afternoon and right away I feel more energetic as if I had a cup of coffee!  When our eyes are dry, they tend to cause eye strain and fatigue.
• Bluetooth speakers.  Music can affect our moods and overall well being.  Some studies have shown that listening to classical music has a calming effect and can also boost cognitive functioning!  The theory is that the melody stimulates different parts of our brain.  Some busy train stations have even started playing classical music to calm busy commuters.
• Sunglasses with thick sides.  Excessive sun exposure can cause damage to the delicate structures of the eyes leading to chronic eye conditions such as cataracts and macular degeneration (which can cause serious vision issues later in life).  It is also important for allergy sufferers to choose sunglasses with thick sides, as pollen is very sticky and can fly into the eye with the slightest breeze causing eye irritation and watering.  Thick sides on sunglasses can prevent this from happening.  I often choose sunglasses that are worn by cyclists as they have this exact purpose in mind.

Summer is a great time to enjoy the outdoors!  However, extreme heat can be very dangerous to your health.  This is especially true for the very young, very old, and people with chronic medical issues such as high blood pressure and diabetes.  Here are some tips to beat the heat this summer.

• Stay hydrated!  Be sure to drink plenty of water.  By the time most of us are thirsty, we are already slightly dehydrated.  As people get older, the thirst center of the brain becomes less sensitive.  Elderly people may not think they are dehydrated until it is too late.  How do you know you are well hydrated?  You should be urinating at least every hour and the urine should be clear, not cloudy or dark colored.  If this is not the case, your body is likely trying to hold onto water.  I would recommend that you start drinking water until you feel the urge to urinate.
• Eat plenty of fruits and vegetables.  Most of these contain over 80% water and can provide more hydration along with electrolytes such as potassium, which is essential to prevent muscle cramps.
• Stay cool, especially when the temperature is over 85 degrees Fahrenheit.  Stay indoors or in the shade particularly between the hours of 12-3 when the sun is very intense.  Drinking cold, non-alcoholic beverages can also keep your body temperature down.  If you feel like you are overheating, jump into a pool or ocean to cool your body temperature down.
• Keep you body covered.  Wear wide brimmed hats or use an umbrella if the you must be outdoors for long periods of time in the sun.  Clothing such as linen can cover up skin, while keeping it cool.
• Avoid excessive exertion.  Save the yard work for a cooler day.  Go running or exercise indoors with air conditioning. Hot, humid, pollen-filled air can trigger respiratory problems in people with asthma or allergies.
• Eat cool foods such as frozen juice pops, salads and cold soups such as gazpacho.  Avoid heavy, greasy, hot-temperature foods.  These can raise our body temperature and can make digestion more difficult.  Avoid grilling as the heat from the grill can also raise your body temperature.
• Check in with people around you, especially the elderly and the young.  Some signs of health issues with heat include:  mental confusion, racing heartbeat (usually over 100 beats per minute), dizziness upon standing, feeling tired/lethargic, shallow and rapid breathing, blurry vision, inability to urinate, nausea, and loss of appetite.