The Inflamed Male | with Diane Pascoe

It's not just achy knees. Inflammation can contribute to low mood, low energy...and yes, moobs.

Underlying inflammation doesn't just cause discomfort. It accelerates ageing and increases the risk of serious chronic disease. The tricky part? Much of it bubbles away quietly under the surface for years before symptoms become obvious.

Sugar | the smooth-talking troublemaker

Even moderate amounts of sugar in the diet can contribute to a process called glycation. This occurs when excess sugars bind to proteins and fats in the body, creating compounds that damage tissues and increase inflammation.

The result? Achy joints, reduced cellular function, oxidative stress, and impaired insulin sensitivity are the key hallmarks of metabolic syndrome.

And it's not always the obvious culprits. Sugars are hidden everywhere: sauces, cereals, "healthy" snack bars, sports drinks, takeaway foods and alcohol.

Belly fat isn't just storage, it's metabolically active

Not all body fat behaves the same way. Visceral fat, the fat stored deep around the organs, is particularly inflammatory.

This type of fat produces inflammatory chemicals and increases aromatase activity, an enzyme that converts testosterone into oestrogen. Lower testosterone levels in men can contribute to fatigue, low mood, reduced muscle mass, increased abdominal fat, and yes… the dreaded moobs.

This creates a vicious cycle:

more visceral fat → more inflammation → lower testosterone → poorer insulin sensitivity → even more visceral fat

That interconnected inflammatory "web" is what drives many of the chronic health issues now seen in men earlier and earlier in life.

The liver cops it too

High sugar intake and visceral fat place enormous strain on the liver.

Over time, blood tests may begin to show elevated liver enzymes such as GGT, ALT and AST. Your GP may refer to this as MASLD — Metabolic Dysfunction-Associated Steatotic Liver Disease (previously known as fatty liver disease).

Without intervention, this inflammatory process can contribute to:

• elevated triglycerides
• increased LDL cholesterol
• insulin resistance
• cardiovascular disease
• and significant liver damage over time.

Stress, sleep and the "cortisol belly"

It's not just food contributing to weight gain around the middle.

Chronic stress increases cortisol levels, triggering the release of glucose and stored fat to prepare the body for danger, useful if you're running from a lion, less useful when you're sitting in traffic or answering emails at 10 pm.

Over time, this stress response contributes to truncal obesity, poor blood sugar regulation, fatigue and low mood.

Then comes the next layer: poor sleep.

If you snore heavily, wake unrefreshed, fall asleep on the couch, or carry excess weight around the neck and abdomen, sleep apnoea may be part of the picture. Sleep apnoea itself increases inflammation, worsens insulin resistance, raises cardiovascular risk and contributes to hormone dysregulation.

A sleep study can sometimes reveal far more than expected.

The gut: inflammation's hidden headquarters

Sometimes inflammation shows up loudly as bloating, flatulence or poor bowel habits. Other times, it's happening silently at the level of the gut microbiome.

Certain microbiome metabolites, including lipopolysaccharides (LPS), Trimethylamine (TMA), excess branched-chain amino acids and mucin-degrading species, may contribute to systemic inflammation.

This inflammatory burden has been linked to:

• insulin resistance
• type 2 diabetes
• oxidative stress
• atherosclerosis
• depression
• and metabolic dysfunction.

Gut permeability, often referred to as "leaky gut," is also an area of active research. When the intestinal barrier is disrupted, including degradation of the protective mucin layer lining the gut, inflammatory compounds and endotoxins may enter circulation more readily.

Diet and lifestyle profoundly influence the microbiome. Excess sugar, ultra-processed foods, alcohol, chronic stress, poor sleep and inactivity all negatively affect microbial balance and inflammatory signalling.

Anti-inflammatory lifestyle medicine

Inflammation is not managed through one magic supplement or a single "detox." The most effective approach is cumulative:

• reducing ultra-processed foods and excess sugars
• improving sleep quality
• increasing movement and resistance exercise
• managing stress
• improving gut health
• reducing visceral fat
• supporting healthy testosterone levels
• and incorporating anti-inflammatory foods, herbs and nutrients where appropriate.

What matters is that you're making small, consistent changes, not that you're doing everything perfectly.

What should men actually monitor?

Inflammation often develops silently long before disease appears. Useful investigations may include:

• CRP and ESR
• fasting insulin and glucose
• liver function tests
• lipid profile
• albumin/globulin ratio
• body composition or visceral fat measurements
• gut microbiome testing
• and sleep apnoea screening where indicated.

Because sometimes the body whispers long before it screams.

If you're ready to explore personalised strategies for chronic inflammation and ageing you can book a consultation with Diane  here.

Diane Pascoe is a naturopathic clinician with decades of experience supporting men and women on their path to better health