The cause of benign prostatic hypertrophy (BPH) is unclear. However, it is clear diet and life style has an affect. We know there are modifiable and un-mondifiable factors to prostate disease. Age, heredity, and genetic disposition may put an individual at risk. However, through the study of epigenetic we are able to see the mechanism by which food may act in turning off those bad genes and then turn on good gene expression through a proper nutrient rich diet. An antioxidant rich whole food plant based vegan diet, incorporating vitamins C, E, and D and selenium, lycopene, omega 3, fresh phytoestrogens, fiber, and physical exercise are all beneficial in healthy gene expression.
Prostate Introduction
The prostate is a gland about the size of a golf ball. It is located underneath the bladder and it surrounds the upper portion of the urethra. The prostate slowly increases in size from birth to puberty. The size of the prostate is generally the same size from 30 to age 45, from there the prostate may continue to increase in size. Benign prostatic hypertrophy (BPH) may result BPH is commonly experienced in men as they age. Lower urinary tract symptoms (LUTS) are associated with BPH. Symptoms of LUTS may include nocturia, frequency, incomplete emptying, urgency, and may be associated with symptoms of sexual dysfunction (Kim, Zhao, Kim, Kim, & Park, 2012). BPH is not a risk factor for prostate cancer. When normal cells are damaged beyond repair they are eliminated by apoptosis. Cancer cells however avoid apoptosis and continue to multiply in an unregulated manner. The symptoms of malignancy can go undetected for many years until disease is advanced and bladder obstruction occurs.
BPH (Benign prostatic hypertrophy) Etiology
The cause of prostate disease is not clear. Components like age, heredity, or genetic disposition may work against an otherwise healthy prostate. However, there are many modifiable elements that men may control. Modifiable risk factors (sex steroid hormones, the metabolic syndrome, obesity, diabetes, physical activity, diet, and inflammation) are adjustable. This ability to modify diet and lifestyle behaviors to influence ones genes, therefore health, is a part of a newly discovered science called epigenetics. Epigenetics studies genes as they are structurally modified from our environment, life style and dietary choices.
Genes do not determine disease on their own. Various compounds found in foods or in environment enhance health or deter it. Genes function only by being activated, or expressed, and nutrition plays a critical role in determining which genes, good and bad, are expressed. Genetic alterations are made by dietary intake during each individual’s life. Even at an embryonic level gene expression is altered and disease may be turned on or off (Canani et al., 2011). In fact the epigenetic mechanisms elicited by nutrition in early life is shown to be a predictor to chronic disease (Beni Canani et al., 2011). For example, Hayes et al. (2012) revealed A mom’s high fat diet has actually been shown to lowers fetal outcome and survival rate by altering the development of placental vasculature.
There are modifiable life-style factors, which influence prostate conditions as well as overall health. For example, many of the same metabolic disturbances associated with cardiovascular disease influence the risk of BPH (Benign prostatic hypertrophy) and LUTS (lower urinary tract symptoms). Metabolic syndrome, a collection of metabolic abnormalities such as obesity, glucose intolerance, dyslipidemia and hypertension, are primarily from dietary and other life-style practices endemic to Westernized societies -style factors, which influence prostate conditions as well as overall health. For example, many of the same metabolic disturbances associated with cardiovascular disease influence the risk of BPH (Benign prostatic hypertrophy) and LUTS (lower urinary tract symptoms). Metabolic syndrome, a collection of metabolic abnormalities such as obesity, glucose intolerance, dyslipidemia and hypertension, are primarily from dietary and other life-style practices endemic to Westernized societies (Patel & Parsons, 2014). In a cohort study men diagnosed with at least three components of the metabolic syndrome had an 80% increased prevalence of LUTS compared with those with no components. (Patel & Parsons, 2014). These observations are important because they suggest novel targets for prevention and treatment.
Obesity. An increase in adipose tissue, body weight, body mass index (BMI), and waist circumference are associated with prostate volume, the greater the amount of adiposity, the greater the prostate volume. In a cohort study each 1 kg/m2 increase in BMI corresponded to a 0.41 cc increase in prostate volume. Moreover, obese (BMI ≥ 35 kg/m2) participants had a 3.5-fold increased risk of prostate enlargement compared with non-obese (BMI
Diabetes and disruptions in glucose homeostasis. Refined carbohydrate and sugars increase exogenous estrogen concentration and should be avoided (Shan, 2006). Diagnosed diabetes is characterized by increased serum insulin and elevated fasting plasma glucose. Diabetes is a disruption in glucose, or sugar, homeostasis and is associated with increased prostate size, enlargement, BPH and LUTS in multiple cohorts incorporating tens of thousands of men. It is the alterations in serum insulin growth factor (IGF), higher serum concentrations of IGF-1 and insulin-like growth factor binding protein 3 (also indicators of diabetes) that are associated with increased risk of clinical BPH. (Patel & Parsons, 2014).
Hormonal Imbalance. Multiple studies have explored associations of endogenous sex steroid hormones testosterone, DHT and estrogen with BPH and LUTS (Patel & Parsons, 2014). There is an association with high serum testosterone (total, bioavailable, or free) with BPH or LUTS. A long-term efficacy and safety trial demonstrated low testosterone in only 21.7% of aging men with BPH (Patel & Parsons, 2014). Exogenous, from external source such as through nutrients or environment, estrogen concentrations should also be controlled for proper hormonal balance (Shan, 2006).
Prostatic secretions make up about 25% of the volume of semen. In prostatic secretory cells, the hormone 5-alpha reductase converts testosterone to DHT, a potent stimulator of prostate growth that, in addition to being necessary for prostate development, appears to play a central role in BPH pathogenesis. There is an increased risk of BPH with increased serum concentrations of DHT and its metabolites. Cross-sectional and a prospective study have shown direct associations. Men with the highest midlife levels of DHT had nearly 3 times the risk of subsequent BPH compared with those with the lowest levels (Patel & Parsons, 2014).These results ring true with studies of serum concentrations of DHT metabolites 17b-diol-glucuronide and androstanediol glucuronide that are surrogate markers for DHT activity. The higher concentrations of these metabolites indicating increased DHT and lower concentrations decreased it (Patel & Parsons, 2014).
Inflammation. A majority of observational studies suggests that inflammation is linked to the development of BPH and LUTS. Inflammation is implicated as a primary stimulus for prostate carcinogenesis and it is possible that BPH represents a non-malignant proliferative pathway promoted by oxidative stress and inflammatory mediators. (Patel & Parsons, 2014). The links between BPH and histological inflammation are strong in surgical specimens. The extent and severity of the inflammation corresponds to the magnitude of prostate enlargement. Men with LUTS are more likely to have higher serum C-reactive protein, a marker of systemic inflammation (Patel & Parsons, 2014). Much of our inflammation can be correlated back to dietary intake.
Diet. There are associations between aggressive prostate cancer and food groups (Hardin, Cheng, & Witte, 2011). Results from a dose–response meta-analysis study suggested that coffee consumption is inversely associated with the risk of fatal prostate cancer (Discacciati, Orsini, & Wolk, 2014).
Refined foods. Diet plays a significant roll in prostate health. Increased consumption of high glycemic index foods for example is positively associated with risk of aggressive prostate disease by 40 to almost 90%. In particular, dark breads (including bagels, rolls, and whole wheat bread), high intake of French fries, potato chips, chocolate, cookies and cakes, and regular soft drinks all exhibited positive associations with aggressive prostate cancer and increase the risks of symptomatic BPH (Hardin, Cheng, & Witte, 2011; Patel & Parsons, 2014). In fact, a study of over 500 Jamacian men evaluated dietary patterns that would most be linked to prostate caner. IT was determined a refined carboydrate pattern , caharterized by intake such as rice, pasta, sweetened beverages, sweet baked goods, etc., was the leading risk factor for prostate cancer. That means according to this study refined carbohydrates were more dangerous than a meat pattern group or even the fast food group (Jackson et al., 2013).
There are indications that nutrients affect the risk of BPH. Increased total energy intake, energy-adjusted total protein intake, red meat and poultry, fat, dairy products and potentially increase the risks of symptomatic BPH. Zinc and vitamin C have been associated with both increased and decreased risk(Patel & Parsons, 2014).
Animal Products. The macronutrients of animal products are shown to generally increase the body’s level of inflammation. Increased energy-adjusted total protein intake, red meat, poultry, and dairy products all increase the risks of symptomatic BPH (Patel & Parsons, 2014). Additionally, there are indications that nutrients sourced from animal products also affect the risk of BPH.
In recently published book called The China Study details to one of the longest and most recognized and significant nutritional studies of the world, China-Cornell-Oxford Project a 20-year study confirmed animal products were demonstrated to directly related to diseases such as heart, diabetes, and cancers of the prostate, breast and bowel specifically. The study concluded high consumption of animal based foods carry higher health risks.
Dairy. Consumption of dairy, including milk, cheese, and others, is associated with increased risk of prostate cancer (Berroukche, Bendahmane, & Kandouci, 2012). Prostate cancer had a direct association with dairy intake.
Red Meat. Consumption of red meat is significantly associated with increasesd risk of prostate cancer (Berroukche, Bendahmane, & Kandouci, 2012). According to an article done by the journal Nutrition and Cancer high levels of dietary protein was the highest dietary risk for prostate cancer (Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014).
Seafood. Although fish oil consumption may be protective against progression of prostate cancer in elderly men only, salted or smoked fish has been shown to increase risk of advanced prostate cancer (Torfadottir et al., 2013).
Healing power of Nutrients
The universal components to good health are especially true for men with prostate issues. An antioxidant rich diet, proper digestion and elimination, healthy hormonal balance, daily physical activity, and making dietary alternations which include avoiding inflammatory intake, addressing vitamin and mineral deficiencies, and new food plan are foundational.
These foods with health promoting, positive affects on genes, phytochemicals are called functional foods because they have potential beyond basic nutrition. Functional nutrition provides favorable results in treatment and reversal of many disease conditions. Evidence based research indicates prostate health is no exception. Peer reviewed research supports these improvements revealing that through nutrition, supplementation, and life style alterations cancer risk is reduced and inflammation levels reversed.
Proper elimination, loading up on antioxidants, incorporating anti-inflammatory nutrients, modifying steroidal nutrition, addressing vitamin and mineral deficiencies, are all easily and validly spoken to without synthetic medications or surgery. Through a nutrient rich diet and natural plant based compounds prostate disease may be treated.
Antioxidants. A foundational component to general good health includes a diet rich in antioxidants. Antioxidants, or live plant foods, are essential in enhancing the body’s ability to fight disease (Stone, Kawaai, Kupka, & Fawzi’s, 2010). According to the Mayo Clinic 13 separate studies found consumption of cruiferous vegaetables such as cabbage, brussel sprouts, broccoli, and cauliflower was associated with a significant decreased risk of prostate cancer. In a significant short-term study a favorable effect on PSA was found following ingestion of a concentrated blend of pomegranate, green tea, broccoli, and tumeric (Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014). Antioxidant rich green tea alone is shown as beneficial additionally (Berroukche, Bendahmane, & Kandouci, 2012). An improvement in health and prevention of prostate disease can be easily made with an antioxidant rich diet.
Vegan Solution. An antioxidant rich diet can be easily achieved with a vegan diet. Albert Einstein stated at the end of his life, “Nothing will benefit human health and increase chances for survival of life on earth as much as the evolution to a vegetarian diet.” This appears to be epesially true for men with prostate disturbances.
The China Study by Dr Colin Campbell, as mentioned before, concluded that people who eat a whole-food, plant-based, vegan diet (avoiding all animal products, including beef, pork, poultry, fish, eggs, and dairy) and reduce intake of processed foods and refined carbohydrates will escape, reduce or reverse the development of numerous diseases.
The plant based dietary constituents reduce the risk of prostate cancer (PC). Increasing intake of vegetables exhibits a significant trend with decreasing that risk. High intake of high carotenoid vegetables was also inversely associated with aggressive prostate cancer, Focusing on specific vegetables, we found decreased risks for each level of consumption of cooked greens (spinach, mustard greens, or collards) and bean soups while the highest intakes of summer squash, garlic, and red peppers conferred decreased risk also. High intakes of berries and orange melon were also inversely associated with aggressive prostate cancer. (Hardin, Cheng, & Witte, 2011). Fruits, vaegetables, and whole grains are famous for their antioxidant value.
Vegan Protein. Leafy vegetables, some of the most protein rich plant foods, are inversely associated with aggressive prostate cancer. Beans, lentils, legumes, a great alternative to animal protein, are an antioxidant rich source of protein and fiber (Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014). In a high dietary intake of legumes found with a vegan diet there was a cancer protective affect (Hardin, Cheng, & Witte, 2011).
Vitamin & Mineral. The risk of BPH significantly decreased with an increasing serum selenium concentration (Eichholzer, Steinbrecher, Kaaks, Teucher, Linseisen, & Rohrmann, 2012). Vitamin C a known antioxidant found abundantly in fruits has also been shown to reduce risk of prostate cancer (Hardin, Cheng, & Witte, 2011; Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014). Carotenoids (particularly found in vegetables), linoleic acid, Vitamin A and Vitamin D potentially decrease the risks of symptomatic BPH and LUTS. (Patel & Parsons, 2014). Higher circulating concentrations of vitamin E and lycopene have also been inversely associated with BPH and LUTS (Patel & Parsons, 2014).
Lycopene. Lycopene is a naturally occurring component that is created in cooking process of tomatoes. Dietary intake of lycopene is associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor. Because angiogenesis is a strong progression factor lycopene appears to act preventatively. Higher lycopene intake reduces the risk of prostate cancer and more strongly in lethal prostate cancer. Higher lycopene intake was then associated with biomarkers in the cancer indicative of less angiogenic potential. (Zu, Mucci, Rosner, Clinton, Loda, Stampfer, & Giovannucci, 2014).
Incorporation of Anti-inflammatory Nutrients. Bringing down inflammation is critical in the treatment of the prostate. Nutritionally boosting the immune system is a common theme in restoring health in chronic conditions. Proper immune function has an anti-inflammatory effect (Shan, 2006). Vitamin C reduces inflammation (Murray, 2010). Echinacea is wildly known as an immune system supporter. Licorice helps to refresh the adrenal glands that can become tired from the stresses of prostate disease. Stronger adrenal glands mean a stronger immune system.
Omega 3. Essential fatty acids form anti-inflammatory prostoglandins which reduce inflammation (Shan, 2006). Essential fats can be found in olive oil (Berroukche, Bendahmane, & Kandouci, 2012), evening primrose, raw nuts such as the walnut, flax seed and sage oils. Healthy diets rich in essential fatty acids also protect the vascular system in the heart and pelvis, and can act as a cancer preventative according to Moral, Escrich, Solanas, and Vela (2011). Fish oil consumption has been shown as protective against progression of prostate cancer in elderly men specifically only. However, in a setting with very high fish consumption, no association was found between overall fish consumption in early or midlife and prostate cancer risk (Torfadottir et al., 2013).
Furthermore, the consumption of diet rich in lignans may decrease the risk of chronic hormonal condition- benign prostatic hyperplasia (BPH). A lignan-rich extract from flaxseed hulls, LinumLife EXTRA (LLE), prevents BPH using the testosterone propionate (TP)-induced BPH. Therefore it is indicated as beneficial in the prevention of BPH. (Bisson, Hidalgo, Simons, & Verbruggen, 2014).
Modifying Nutrients for Hormonal Balance. In minimal doses of herbs that are steroidal saponins may be indicated for prostate health. A steroidal saponin is a naturally occurring fat-soluble adrenal or sex hormone like compound found in a plant source. They can support hormone balance and are a natural agent for the endocrine system. Vitex (chaste tree berry) influences pituitary function and works to balance hormones while not containing hormones itself. It works to correct the problem at the source (Murray, 2010). Maca is a superfood that works to regulate hormones in the body. Maca also does not contain any hormones in itself, it works by nourishing and balancing the endocrine system (Murray, 2010). Testosterone replacement therapy has the potential for decreasing BPH and LUTS. Observations imply that higher serum testosterone concentrations are potentially protective. (Patel & Parsons, 2014).
Excessive or insufficient nutrient content from diet affects the estrogen concentrations (Shan, 2006). Phytoestrogens are dietary estrogens like chemicals found in plants. Phytoestrogens include flavonoids and lignans. and they act as antioxidants. Phytoestrogens mimic and act as an antagonist of estrogen (Yildiz, 2005). This is because estrogesn and phytoestrogens have silimarities at a molecular level. Phytoestrogens are then allowed to mildly mimic and sometimes act as antagonists of estrogen. When consumed they have an estrogenic or antiestrogenic effect depending on stage of life, gender, content of dietary intake and the body’s sex hormone concentration level. Several studies associate phtytoestrogens with reduced risk of breast and prostate cancer. This is especially helpful to men with an estrogen dominant conditional like cancer. It is the unopposed estrogen that has been associated with cancer risk. Removal of excess estrogen is vital to overall hormonal balance (Murray, 2010).
Evidence is accruing that phytoestrogens have protective action against most prostate health disorders (Adlercreutz, 2002; Johnston, 2003; Yildiz, 2005; Zhao, & Mu, 2011). High phytoestrogen intake specifically decreases serum concentrations of prostate specific antigen (PSA) (Walser-Domjan et al.,2013). In fact, a 46% decreased risk of prostate cancer was found with the use of phytoestrogen rich soy (Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014). This is likely due to the various compounds in soy that influence estrogen metabolism and elicit androgenic effects, which in turn inhibit testosterone-induced cell proliferation. Moreover, soy isoflavones are shown to positively influence PSA levels (Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014).
However, soy consumption has become controversial. Some studies reveal the benefits and cancer prevention components while others link the two. Soy is not the only source of phytoestrogens. Flaxseed, nuts and seeds, and herbs are also good sources of phytoestrogens (Thompson, Boucher, Lui, Cotterchio, & Kreiger, 2006). Diets full of fresh vitamin and mineral rich green vegetables prevent the accumulation of estrogens. DIM is a concentrated version of greens; it balances the hormones and aids in the breakdown of estrogen. DIM acts as an epigenetic modulator effecting DNA and cancerous prostate epithelial cells. DIM excretes a chemoprotective effect (Wong et al., 2014).
Phytoestrogen Food Source Listed from highest content to lest (µg/100g): Flax seed (379380), Soy beans (103920), Sesame seed (8008.1), Multigrain bread (4798.7), Hummus (993), Garlic (603.6), Mung bean sprouts (495.1), Dried apricots (444.5), Alfalfa sprouts (441.4), Pistachios (382.5), Dried dates (329.5), Sunflower seed (216), Chestnuts (210.2), Olive oil (180.7), Almonds (131.1), Cashews (121.9), Green bean (105.8), Peanuts (34.5), Onion (32), Blueberry (17.5), Corn (9), Coffee regular (6.3), and Watermelon (2.9) (Thompson, Boucher, Lui, Cotterchio, & Kreiger, 2006).
Additional food items with high phytoestrogen (µg/100g) and lignan (µg/100g) content include: Vegetables (Soy bean sprouts, Winter squash, Collards, Broccoli, Cabbage), Fruits (Dried prunes, Peaches, Strawberry, Raspberry), Nuts and other legume seeds (Pistachios, Chestnuts, Walnuts, Hazel nuts, Lentils), Beverages (Red Wine, Green Tea, White Wine, Black Tea, Decaffeinated coffee, Beer), and Others (Black bean, Black licorice, Rye) (Thompson, Boucher, Lui, Cotterchio, & Kreiger, 2006).
Elimination. A foundation to wellness includes a properly active digestive system and healthy tissue of the gastrointestinal (GI) tract. Elimination and circulation are essential to good health and regulatory function. Without proper elimination toxins remain in the body and diseased cells are allowed to proliferate. This is especially true for people with endocrine disorders. Nutrients need to be properly delivered and absorbed into a healthy gut. Food intolerances, abnormal gut flora, or other malabsorption issues hinder this process and should be addressed. Herbs that support circulation in the pelvic region include Hawthorn, ginger, and cayenne. Proper elimination also helps alleviate painful: defecation, urination, and sexual intercourse.
Fiber. Fiber is either soluble or insoluable and it adds in the lower of cholesterol, normalization of blood sugar, and helps regulate bowel function. Soluable fibers attract water, form a gel, and slow down digestion for greater sense of satiety, beneficial insulin effect, and help lower LDL cholesterol. Lentils, nuts, legmes, and fruits are good source of soluble fiber. Insoluble fibers are not soluble in water, add bulk to diet, nad have a laxative effect. Passing through Gastrointestinal tract nearly whole food and waste are speed through. Whole grains and vegetables are sources of insoluble fiber. Grains are the seeds of the plant. When they are whole they include the endosperm, germ, and bran, which have lots of nutrients. The refining of grains removes many nutrients, natural phytochemicals, and fiber. Even if some vitamins and minerals are added back into finished product it still will have fewer phytochemicals and no fiber. Whole grains are low in fat and may reduce energy intake because they create a full sensation.
The reason is not entirely clear however, African Ameican men have shown higher incidences of prostate cancer than Caucasian men. Race has therefore be a component in much research of prostate cancer. Regardless the race however dietary fiber is shown to have a protective effect against prostrate cancer in all men (Deschasaux et al., 2014; Tabung et al., 2012).
Physical activity. Increased physical activity and exercise have been robustly and consistently linked with decreased risks of BPH and LUTS. A meta-analysis of 11 published studies (n = 43,083 men) indicated that moderate to vigorous physical activity reduced the risk of BPH or LUTS by as much as 25% relative to a sedentary life-style, with the magnitude of the protective effect increasing with higher levels of activity (Patel & Parsons, 2014). Furthermore, an additional study done with National Health and Nutrition Examination Survey discovered for every 1 hour increase in sedentary behavior participants were 16% more likely to have an elevated PSA concentration (Loprinzi, & Kohli, 2013).
Physical activity does more than just burn calories and reduce PSA levels. Exercise can decrease a man’s level of stress, anxiety, and improve autonomic functions (Sengupta, Chaudhuri, & Bhattacharya, 2013). Peaceful exercise triggers neurohormonal mechanisms by suppression of sympathetic activity. This helps to awaken the parasympathetic nervous system that is helpful in a man’s ability to rest, conduct appropriate digestion, and improves reproductive health. The study by Sengupta, Chaudhuri, & Bhattacharya (2013) suggests that regular yoga practice specifically proves to enhance reproductive health, produce pregnancy, and regulate sexual desire.
Conclusion
Nutrition represents the combined activities of countless food substances and whole is greater than the sum of its parts. Weather for general health or to treat or prevent prostate disturbances diet needs to contain antioxidant rich whole unrefined plant based foods. To lower levels of inflammation animal products and refined processed products should be removed. Genes do not determine disease on their own but function from activation from nutrients or environmental factors. Nutrition plays a vital role in this determination which genes, good and bad, are expressed. The same nutrients may act both preventatively or as an agent of change in presence of disease and may even act protectively against environmental or internal stressors or chemicals. Nutrition that is good for one disease will also support and create general health. PHB will benefit and symptoms and disease relieved with dietary alterations.
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Restorative Source 