Bosom buddies

Male breast reduction surgery is a booming business. While most industries are in a downward tailspin, breast reduction surgery in men is growing at double-digit rates.

Other efforts, some legitimate, some not, are also cropping up, all intended to help men deal with this embarassing problem:

Exercise programs to reduce male breast size.

Liposuction--Not just for the belly!

Plastic surgery

Gynexin--a supplement that purportedly reduces male breast size.

Conventional medical treatment also includes estrogen blocking drugs, the same ones used to treat breast cancer, drugs like tamoxifen. There's even clothing intended to make breasts less obvious.

While male breast enlargement--"gynecomastia"--can occasionally occur due to rare endocrinologic problems, such as high prolactin hormone levels (hyperprolactinemia) or somewhat more commonly as failed testosterone production (hypogonadism), the vast majority of men who suffer with this problem simply have high estrogen levels.

Makes sense: Women develop larger breasts during development mostly due to increased levels of estrogen. A parallel situation in men likewise stimulates breast tissue.

So where does the excess estrogen come from?

Visceral fat converts testosterone to estrogen. Men with excess visceral fat therefore develop low levels of testosterone and high levels of estrogen. Estrogen levels can, in fact, be substantially higher compared to slender males.

So what foods cause the accumulation of visceral fat and, thereby, increased estrogen and decreased testosterone?

Foods that increase blood glucose and insulin to the greatest degree are the foods that begin this cascade. The common foods that increase blood sugar the most? Here's a list, starting with most blood glucose-insulin provoke at the top, least at the bottom:

Gluten-free foods (dried, pulverized cornstarch, rice starch, potato starch, tapioca starch)
Whole wheat bread
Milky Way bars
Snickers bars

So the whole wheat sandwiches you've been eating increase blood sugar and insulin, leading to visceral fat. (And, yes, whole wheat bread increases blood sugar higher than Milky Way bars and Snickers bars.) The more visceral fat grows, the more resistant to the effects of insulin you become, further escalating blood sugar. Estrogen increases, testosterone drops, mammary gland tissue grows, normal male breasts grow to B- or C-cup size.

Yet again, an entire industry is growing from the unintended consequence of conventional advice. In this instance, the advice to "eat more healthy whole grains" leads to this booming industry of male breast reduction efforts from surgery to medications to clothing. The REAL solution: Eliminate the foods that start the process in the first place.

Comments (22) -

  • Sara

    10/8/2010 6:54:43 PM |

    Man-boobs: Another reason to lay off the Doritos.

  • Anonymous

    10/8/2010 7:28:09 PM |

    I'm usually the first to say, "Hoooray for boobies!" Maybe not this time though.

    I've known about man-boobs for a while and I have noticed many thinner guys having them too. It makes me wonder how much fat is inside that that slimmer body.

    What does a man do with their own boobs though?  Hmm... a new potential market!


  • Anonymous

    10/8/2010 7:35:42 PM |

    not just grains.. also too much fruits and fruit juices.

    off topic Q: 47y male, very busy, but otherwise fit and lean, on paleo since a few months, has CRP=0, A1c=5.5, homocysteine=11, TSH=3.4, cholesterin 4.1mmol. low vitamin D (about to be remedied). his father has some bypasses. do you think to stay low-carb'ish paleo is sufficient here, or should he do something about his TSH and homocysteine (it's my brother). can this be caused by drinking 8-10 coffees a day lol? thanks!

  • Anand Srivastava

    10/8/2010 7:37:51 PM |

    Soy also contains a lot of phytoestrogens. Another thing to get rid of.

  • Againstthegrain

    10/8/2010 8:48:55 PM |

    Ditch flax, too.  

    Hmmm, is the rate of male breast cancer rising, too I wonder?

  • Anonymous

    10/9/2010 3:18:21 AM |

    not just for men
    heaps of my female patients want breast reduction surgery
    I tell them to start eating green veges and more fish, and kill the carbs, but most would prefer the surgery because the healthy option is too hard!  go figure

  • Anonymous

    10/9/2010 4:13:52 AM |

    the sad thing is for some of us even when we lose the weight, or the vast majority of the weight, the male breasts still don't go away. I have my gynecomastia surgery schedule for's been a dream of mine for several years and i've been saving for it for a long time.

  • Garth Huckabay

    10/9/2010 11:31:10 AM |

    I read that drinking milk can cause a substantial insulin response even greater than that of a snickers bar?  There are a whole lot of people out there addicted to milk.  Telling them they shouldn't eat bread and pasta mortifies but adding dairy to the equation puts them right over the top Smile

  • Me

    10/9/2010 3:03:19 PM |

    Not to split hairs, but glycemic load, which is what raises blood insulin,  is an entirely dose-dependent variable.

    According  to Nutritiondata. com, a Snickers bar comes in three sizes.

    "Fun size" (15g) GL of 5
    I bar (2 oz)  GL of  57
    I king size bar (4 oz) GL of 113

    Whole wheat bread, commercially prepared
    1 slice: GL of 5

    So, yes if you had two slices of WW bread, you've doubled the amount of a fun-size Snicker.  But eat the big Snickers and you are way, way over that.

    The devil is in the details.

  • Anonymous

    10/10/2010 12:06:06 AM |

    Great post.  I'm sorry it wasn't there 2 years ago when I was working with a male client who was in despair about the man boobs.


  • Larry

    10/10/2010 1:54:24 AM |

    Could low Testosterone blood levels in the male population be the cause of this ?
    There's a detailed article on this matter in the June 2010 LEF magazine.
    The article shows that this deficiency is in epidemic numbers.

  • Dr. William Davis

    10/10/2010 12:43:39 PM |

    Hi, Me--

    Absolutely correct.

    However, you will find that, of the foods listed, ALL increase blood glucose not a little, but a lot. Drawing distinctions among them and declaring one is better is like telling people that Marlboros are bad for you and Salems are better. Therefore, smoke more Salems.

    It's that bad.

  • CarbSane

    10/10/2010 1:09:27 PM |

    I'm curious about your statement that visceral fat converts testosterone to estrogen --> the man boobies.

    There's the implication then that visceral fat leads to low testosterone.

    This study would indicate that the direction of causation may be the other way around.  Visceral and total fat were measured in 110 Japanese-American men and measured again 7.5 years later.  Those with low testosterone levels at the beginning of the study had increased visceral fat.  

    Visceral fat produces estrogen and that can lead to man boobies.

    So lowT --> belly --> boobs seems a more likely scenario.  

    I'm not sure we can look to a booming plastic surgery business for male breast reduction as being indicative of some sort of dietary induced increase in the incidence of man boobs.  Undergoing the knife has become increasingly popular for all sorts of procedures for men.

    I would also add anecdotal evidence that many of the overweight men I know with this problem also happen to carry more weight in their butts, legs and subQ belly rather than sporting the "pot-belly".

  • Kevin

    10/10/2010 6:59:17 PM |

    After being diagnosed with BPH I specifically looked for a remedy other than 5-alpha reductase inhibitors.  I found and used beta-sitosterol for nearly a year.  Eventually I noticed nipple sensitivity.  I read it's an early symtom of gynecomastia.  Then I found that beta-sitosterol acts as a 5-alpha reductase inhibitor.  I quit using the medication about six weeks ago and now have significantly less sensitivity.  But the tradeoff is now I'm back to nocturia.  


  • vitamin c

    10/12/2010 2:46:53 AM |

    It really looks awful for a man to have boobies and that's one that turns me off. I don't want to be with a man be with bigger boobs than I am. Is soya included in the list of food to be avoided?

  • Kathryn

    10/12/2010 6:53:40 AM |

    And soy, soy, soy.  It is being promoted as a "health food" but most of it is genetically modified (unless organic) & all of it is high in plant estrogens.  NOT good for anyone:  women, men, developing children. (Unless it is fermented, not typical.) What is the formula most commonly used for babies?  Soy & lots of sugar.  

    Bad, bad stuff.

  • buy viagra online

    10/12/2010 9:49:38 AM |

    Very interesting Blog.

    Smith Alancli

  • renegadediabetic

    10/12/2010 3:19:03 PM |

    I too would add soy to the list.  All these "healthy" foods aren't so healthy.  They are being promoted as "healthy" because they make $$$$ for big processed food.

    I once saw an ad from PCRM telling men to go veg to reduce man boobs.  However, going veg would just mean more soy and insulin-dirupting foods, which would make the problem worse.

  • Anonymous

    10/12/2010 4:43:37 PM |

    Thank you so much for this info. My family has been gluten free for several years, but I still react to GF breads. Most of our dietary decisions have come about through observing how we react to particular foods, even when we don't understand *why*. I've been avoiding "GF" breads because I react so badly to them . . . and now I know why. Thanks for the verification.

  • Anonymous

    10/27/2010 5:16:16 PM |

    Men who are taking the BP med sprionolactone (trade name Aldactone) can sometimes experience gynecomastia. It's an uncommon, but well-known side effect of some drugs, and not always just a function of food intake or exercise (or lack thereof).

  • Rogue Dietitian

    11/6/2010 10:58:22 PM |

    You forgot one VERY important thing on your list:


    Ethanol promotes aromatase converting testosterone to estrogen. Also, lupulin in hops is a potent phytoestrogen making beer a double whammy.

    I would also like to add that brassica vegetables (broccoli, cauliflower, kale, cabbage, Brussels sprouts, etc) are rich in indole-3-carbinol and diindoylemethane which are wonderfully potent anti-estrogenic molecules.

  • bactrim

    11/7/2010 2:11:37 PM |

    If you are clever you always can money from anywhere or from nothing Smile