Recent epidemiological research shows that lifestyle factors associated with metabolism, such as obesity, exercise, diet, and blood glucose levels, have a substantial impact on the development of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). This information is important because it suggests men can take active steps toward preventing and treating these common conditions by modifying their lifestyle.
In a new review of the literature, J. Kellogg Parsons, MD, MHS, associate professor of surgery at the University of California, San Diego, Moores Cancer Center, outlined the modifiable lifestyle factors that contribute to the development of BPH and LUTS. These two conditions are often studied together because BPH is the main cause of LUTS.
Lifestyle factors impact risk of BPH and LUTS
In the review, Parsons named three factors associated with an increased risk of both BPH and LUTS: obesity, diabetes, and consumption of meat and fat. He noted that most studies have found a relationship between obesity and an increased risk of both BPH and LUTS, including a Norwegian study of 21,700 men (Seim 2005) and the seven-year prospective analysis of 5,700 men who participated in the Prostate Cancer Prevention Trial. (Kristal 2007)
Parsons stated that “disruptions in glucose homeostasis have been strongly and robustly associated with a higher likelihood of prostate enlargement, BPH, and LUTS” in a variety of studies involving tens of thousands of men. Results from the Prostate Cancer Prevention Trial also show that meat and fat consumption are associated with an increased risk of BPH and LUTS. (Kristal 2008)
On the positive side, lifestyle factors found to help reduce the risk of BPH and LUTS include exercise, vegetable intake, and alcohol consumption. Regarding exercise, Parsons noted a 2008 study in which a meta-analysis of 11 studies involving 43,083 men found that moderate to vigorous exercise was associated with up to a 25 percent reduced risk of both BPH and LUTS. (Parsons 2008)
Vegetable consumption can reduce a man’s risk of BPH and LUTS, (Kristal 2008) and benefits are especially good for higher blood levels of carotene and lycopene, which are found in high concentrations in vegetables such as tomatoes, carrots, and greens. (Tavani 2005; Rohrmann 2004)
The research findings on alcohol consumption are mixed. While a meta-analysis of 19 studies involving 120,091 men found a 35 percent reduced likelihood of BPH among men who drank moderately daily, the study also found an increased risk of LUTS. (Parsons 2009)
Parsons also reported that research thus far has not reached any definite conclusions about the associations between cholesterol/triglycerides and BPH and LUTS, nor between smoking and both of these conditions.
This review suggests that modifiable lifestyle factors, including exercise, obesity, diabetes, diet, and alcohol consumption have a substantial impact on the development of BPH and LUTS. Parsons thus noted “there is little, if any, downside to promotion of healthy lifestyle interventions—weight loss, exercise, decreasing meat and fat intakes, and increasing vegetable intake—among BPH and LUTS patients.”
Kristal AR et al. Race/ethnicity, obesity, health related behaviors and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. J Urol 2007; 177:1395–1400.
Kristal AR et al. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: Results from the Prostate Cancer Prevention Trial. Am J Epidemiol 2008; 167:925–34.
Parsons JK. Lifestyle factors, benign prostatic hyperplasia, and lower urinary tract symptoms. Curr Opin Urol 2011; 21:1-4
Parsons JK, Im R. Alcohol consumption is associated with a decreased risk of benign prostatic hyperplasia. J Urol 2009; 182:1463–68.
Parsons JK, Kasheﬁ C. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol 2008; 53:1228–35.
Rohrmann S et al. Association between serum concentrations of micronutrients and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey. Urology 2004; 64:504–9.
Seim A et al. The prevalence and correlates of urinary tract symptoms in Norwegian men: the HUNT study. BJU Int 2005; 96:88– 92.
Tavani A et al. Intake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: A Case–Control Study from Italy. Eur Urol 2006 Sep;50(3):549-54.