This month, our Sussex health expert takes a look at the sensitive but important issue of men’s prostate problems. After about age 40, the prostate begins to grow in nearly all males. Sometimes the enlargement is a sign of cancer, but usually the result is benign prostatic hypertrophy / hyperplasia, or BPH. For most men, as BPH develops, the prostate presses against the neck of the bladder or urethra, causing obstruction to urinary flow. Also, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder.
The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH, including:
- Urgency—the need to go immediately
- During urination, the flow stops and starts instead of a full, steady stream
- Hesitancy or difficulty starting urine flow
- Dribbling after urinating
- Nocturia—having to get up frequently at night to urinate
- Increased frequency of urination
- Increased risk of infection if the bladder does not empty entirely and urine is retained
75% of men by the age of 55 have BPH. Because BPH cannot be cured, treatment focuses on reducing the symptoms.
- After the fifth decade, testosterone levels decrease while other hormones such as prolactin and oestrogen are increasing
- Increased conversion of testosterone to a hormone called dihydrotestosterone (DHT), which increases the turnover of cells in the prostate. The increasing cell turnover not only enlarges the prostate but also increases the risk of mutated cells forming and hence the development of cancer
- Oestrogen increases the activity of DHT
- Increased levels of prolactin increase the uptake of DHT in the prostate. The primary causes of raised prolactin are beer and stress
- Possible links to diet
- Genetic predisposition
- Toxicity – heavy metals, petrochemicals and rubber all increase the risk of BPH and prostate cancer. Similarly, urban areas have higher incidences as opposed to rural, which is thought to be due to environmental pollution
Research indicates that men who eat fruits, vegetables and whole foods rich in lycopene and selenium, have lower rates of cancer than those who eat a poor diet high in saturated animal fats and red meat. Whilst men in China and Japan typically have low rates of prostate cancer, when they emigrate to the USA or UK and change their eating habits, they develop it at the same rate as the native population.
Specific foods known to support prostate health include:
- Salmon: Salmon is rich in omega-3 fatty acids, which help prevent and reduce inflammation within the body. Other cold-water fish, such as sardines and trout, are also rich in these types of fats.
- Tomatoes: Tomatoes are packed with lycopene, an antioxidant that may benefit prostate gland cells. Cooking tomatoes, such as in tomato sauce or soup, helps to release the lycopene and make it more readily available to the body.
- Berries: Strawberries, blueberries, raspberries, and blackberries are excellent sources of antioxidants, which help to remove free radicals from the body.
- Broccoli: Broccoli and other cruciferous vegetables, including bok choy, cauliflower, Brussels sprouts, and cabbage, contain a chemical known as sulphoraphane. This is thought to target cancer cells and promote a healthy prostate.
- Nuts: Nuts are rich in zinc, a trace mineral. Zinc is found in high concentrations in the prostate and is thought to help balance testosterone and DHT. Shellfish and legumes are also high in zinc.
- Citrus: Oranges, lemons, limes, and grapefruits are all high in vitamin C, which may help to protect the prostate gland.
- Onions and garlic: Research indicates that men with BPH tended to eat less garlic and onions than men without BPH.
- Avocados: Avocados are rich in a plant sterol called beta-sitosterol, that is thought to reduce symptoms associated with BPH. Other foods rich in beta-sitosterol include soybeans, pumpkin seeds, wheatgerm, pecans.
- Green tea – the incidence of prostate cancer in China, a population that consumes green tea on a regular basis, is one of the lowest in the world. Recent studies have shown that one of green tea’s active ingredients – epigallocatechin-3-gallate—blocks the growth of prostate cancers.
Nutritional supplement treatment options
- Grape seed extract – contains potent antioxidants called proanthocyanidins. Studies have shown that grape seed extract can inhibit abnormal cell growth and promote cell death in human cancerous prostate cells.
- Lycopene – a powerful antioxidant that is found in red fruits and vegetables, especially tomatoes, watermelon, red grapefruit, and guava. Researchers have linked the frequent use of lycopene from tomatoes to a lower risk of prostate and other cancers.
- DIM – Diindolylmethane is a natural metabolite of phytonutrients found in cruciferous vegetables like broccoli, kale and brussels sprouts. DIM has been shown to inhibit an enzyme called aromatase, which converts testosterone to oestrogen. Multiple studies have found that taking a supplement of DIM results in an overall reduction of BPH symptoms, including reduced night-time urination. Research also shows that taking DIM for 28 days lowers prostate-specific antigen (PSA) levels in men with prostate cancer.
- Vitamin E – is a vital antioxidant that protects cells from the ageing process, particularly those involved in the reproductive system.
- Selenium – Research has shown up to a 63% reduction in prostate cancer in men who received a 200 mcg supplement of selenium. Selenium is found naturally in tuna, Brazil nuts, and sunflower seeds.
5-alpha-reductase is an enzyme that is involved in the irreversible conversion of testosterone to DHT. The following supplements all inhibit 5-alpha-reductase and are therefore useful in preventing the progress of BPH:
- Zinc – best taken in picolinate form to aid its absorption.
- Pygeum africanum – many studies have shown the effectiveness of Pygeum extract in treating BPH. It has been shown to relieve various symptoms, including reduction of the frequency of night-time urination.
- Nettle root – is well documented and recognized to relieve symptoms of BPH.
- Saw Palmetto – repeated double-blind studies have demonstrated that saw palmetto berry extract is effective in relieving the major symptoms of BPH, including increased night-time urinary frequency. Saw palmetto actively shrinks the prostate gland by killing prostate cells.
- Quercitin – research has shown that men taking quercetin experience improvement in various BPH symptoms and an increase in urine flow rates.
- Agnus castus (Chaste Tree) – research suggests that Agnus castus contains active ingredients that inhibit cell turnover and induce cell death in the prostate and is therefore considered useful for the prevention and/or treatment of both BPH and prostate cancer.
- Black cohosh – contains one or more potent 5-alpha-reductase inhibitors which make this extract suitable for the prevention and treatment of prostate cancer and BPH.
Article contributed by Dr Tracy S Gates, DO, DIBAK, L.C.P.H., Consultant, Pure Bio Ltd. Copyright © Pure Bio Ltd 2021. All rights reserved.
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