A dietary approach to prostate health
The awareness of men’s health has become more visible in recent years with the help and awareness driven by organisations such as the Movember Foundation, which have made the topic more accessible with their brilliant approach that resonates perfectly with men of all ages.
There are numerous health issues related to men, which encompass both mental and physical health and include conditions such as infertility, impotence, depression, overweight and those related to the prostate. Despite the raised awareness, many men still find it difficult or embarrassing to seek help and this is heavily influenced by social stigma, which is a key consideration in the promotion of men’s heath as it creates a barrier to men seeking help and advice.
Prostate health is unique to men and is typically correlated with age given that conditions associated with it mostly affect male baby boomers (aged 54-74 years) and Gen X (aged 39-53 years). Diet and lifestyle have a key role to play in prostate and many other areas of health and establishing good habits from an earlier age will pave the way to better health in the long-term.
What is the prostate?
The prostate is a small gland about the size of a walnut, which surrounds the tube (urethra) responsible for carrying urine out of the body and also secretes fluid that nourishes and protects sperm.
Common prostate health complaints include benign prostatic hyperplasia (BPH) or enlarged prostate. The prostate gland naturally continues to grow with age but can cause troublesome symptoms in men with BPH, which make it difficult to urinate and empty the bladder. Other prostate heath conditions include prostatitis (inflammation of the prostate, which can occur from the age of 30) and prostate cancer, which incurs more than 40,000 newly diagnosed cases every year in the UK making it the most common form of cancer amongst men.
Symptoms of both BPH and prostate cancer are similar given they are both related to an enlarged prostate and include:
- Frequent urination
- Weak or interrupted urine flow or the need to strain to empty the bladder
- The urge to urinate frequently at night
- Blood in the urine
- Blood in the seminal fluid
Prostate cancer is a big health issue amongst men but is slow to develop meaning symptoms may not occur for many years until the prostate is large enough to affect urination. An enlarged prostate does not mean you have cancer, but the symptoms shouldn’t be ignored. The causes of prostate cancer are largely unknown, but the risk is increased beyond the age of fifty and for reasons as yet unclear the disease appears to be more common in men of African-Caribbean or African descent. There also seems to be a slight increased risk in men with a family history of prostate cancer.
A reliable method of screening for prostate cancer is yet unavailable and early detection relies on vigilance about symptoms and regular check-ups with your GP. A blood test called prostatic-specific antigen (PSA) test is available but is not specific to prostate cancer and PSA levels can be raised as a result of other non-cancerous conditions. If you have raised PSA levels, then you may be offered an MRI scan to help further diagnose the risk of cancer.
Men’s attitudes to health
Research has shown how men are less likely to engage and react to healthcare information or recall the warning signs of cancer when compared to women (1,2). The cultural script of men has imprinted a definition of masculinity characterised by a need to be tough, brave, strong and self-reliant, which can influence their attitudes towards seeking help and overall self-care. Phrases such as ‘man up’ are now common place in our lingo used by men and women alike and are a good example of how this characterisation of men continues to be enforced.
Boys from an early age are often led to believe that if they don’t exhibit these characteristics of the ‘traditional’ male then they will in some way lose their status and respect as men, which contributes to many of the issues surrounding men’s health. Kids story books and animated movies are riddled with such characterisations of princes and superheroes relied upon to save the day, which is often (rightly) fiercely protested against by women seeking equality but is less considered as to the impact on young men and the contribution to social stigma putting pressure on men to behave in a certain way.
The importance of diet on health
Research convincingly shows that people who eat a healthy diet are more likely to live longer and have a reduced risk of disease, but the link between diet, food and specific health conditions is often less clear. It’s the overall diet that has the greatest impact on health but in the case of prostate health there are some studies to suggest that certain foods and nutrients may be particularly beneficial. Most of these benefits can be achieved by eating a healthy balanced diet but introducing certain foods may be worth paying some consideration to.
How can diet help with prostate health?
I don’t want to sound boring, but you have to get the basics right first. The modern dialogue around nutrition is overly focused on individual nutrients and foods, whilst the nature of the current wellness landscape gives more credence to the latest fads and diet trends over the basic principles of healthy eating. Focusing on eating a balanced diet can help insure micronutrient intake and also help you to maintaining a healthy body weight, which is one of the best things you can do to reduce your risk of ill health. This is particularly relevant to prostate cancer as findings from the World Cancer Research Fund (WCRF) have shown a strong association between being overweight or obese and the risk of developing the disease (3).
Start with the basics
Start by eating three meals daily and cutting out snacks unless you really need to include them. Pile the veggies high, limit your intake of red meat, switch to ‘brown’ carbs and wholegrains, choose healthy fats (olive oil, avocados, nuts, seeds), cut back on sugar, watch your salt intake and serve small portions of food to help manage your weight.
Eat more salmon
Oily fish such as salmon are the richest source of omega 3 fatty acids, which we need to obtain from the diet. Intake of oily fish in the UK is low with very few people including this food in their diet. Omega 3 fatty acids have been shown to help reduce inflammation in the body, which may help to relieve the symptoms of BPH. Salmon fillets can be marinated to make them more interesting or added to dishes such as fish pie, curry and salads.
Get more fibre in your diet
High-fibre foods include fruits (fresh and dried), vegetables, wholegrains, nuts, seeds, beans, pulses and lentils. According to the National Diet and Nutrition Survey only 13% of men meet the recommended dietary guidance of 30g per day and this is most likely due to choosing refined carbohydrates, not eating enough vegetables and ignoring foods such as beans and pulses (4). Dietary fibre can help to reduce the risk of constipation, which can put pressure on the bladder and worsen symptoms of BPH. Eating more fruits and vegetables is probably the easiest and most effective change you can make to your diet to significantly improve your health. Many foods in this group contain a good source of vitamin C, which is also thought to help relieve the symptoms associated with BPH (5). Most of us get more than enough vitamin C in our diet but foods such as berries, peppers, citrus fruits, broccoli and cauliflower are good sources.
Cut down on fizzy drinks, alcohol, caffeine and artificial sweeteners
You should try and avoid drinking anything up to two hours before bedtime to lessen the need to use the bathroom during the night. Fizzy drinks, alcohol, caffeine and artificial sweeteners can all irritate the bladder and worsen the symptoms of BPH so you should try limiting your intake of these types of drinks.
Eat foods rich in beta-sitosterol
Foods rich in a plant substance called beta-sitosterol have been shown to reduce the symptoms of BPH including urinary flow and volume and may help to lessen the effects of inflammation and prostate growth. Foods rich in beta-sitosterol include seeds, extra virgin olive oil, avocado, nuts, raw cacao and fresh coriander.
Include soy foods as part of your diet
There’s a little research to suggest that phytoestrogens (plant compounds that mimic the effect of the hormone oestrogen) found in soy called isoflavones may help to relive the symptoms of BPH. Soy isoflavones can be found in foods such as tofu, soya milk, soya yoghurt, miso, tamari, edamame beans and tempeh. These foods have also been shown to help reduce cholesterol, making them a healthy addition to the diet and are a great alternative to animal protein for those looking to go meat-free. Swapping dairy products for soy is the simplest way to start including it in your diet.
Soy is one of the most controversial foods and you may have heard of the research linking it to the growth of ‘man boobs’. Firstly, the effect of plant oestrogens on hormonal balance is weak and secondly, the research involved the consumption of unrealistically huge amounts of soy milk every day.
Eat plenty of foods rich in zinc
This mineral is very important for men, who have a higher daily requirement than women. Zinc is essential for male reproductive health, which includes proper prostate function. Research has suggested that men suffering with BPH and prostate cancer may have lower levels of zinc, but this is not considered a risk factor for either condition. You can get plenty of zinc in your diet by eating foods such as shellfish, meat, pulses, beans, wholegrains, nuts, seeds and eggs.
Red fruits and vegetables
Red fruits and vegetables are rich in the antioxidant phytonutrient lycopene. Tomatoes are the richest source, especially when cooked or processed but other foods include red peppers, pink grapefruit and watermelon. Lycopene has long been associated with reducing the risk of prostate cancer but updated findings from the WCRF have downgraded the evidence to support this link from ‘strong’ to ‘no conclusion possible’ in light of the current available research (3). Lycopene may still be beneficial for prostate health and these new findings don’t mean that it’s suddenly redundant, but only that the new research has made it more difficult to establish a link to prostate cancer.
A healthy balanced diet is important for all areas of health, which includes that of the prostate. Focusing on food and managing your weight are significant ways to help promote good prostate health and the sooner you adopt healthy eating habits the better. All men over fifty should be vigilant about recognising the signs of prostate cancer and seek regular check-ups with their GP as a habitual part of their lifestyle.
For more advice on prostate cancer visit the NHS website here.
For more information on mens health and diet try reading these blogs