High Vegetable Intake Linked to Lower Risk for BPH

Men who have a high intake of vegetables, particularly those rich in beta-carotene, had a reduced risk for benign prostatic hyperplasia (BPH), according to the results of a study reported in the February issue of the American Journal of Clinical Nutrition.

"Nutrients with antioxidant properties or that influence cell growth and differentiation might reduce the risk of benign prostatic hyperplasia (BPH)," write Sabine Rohrmann, PhD, MPH, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues. "We examined the association of fruit and vegetable consumption and the intake of micronutrients with BPH in a large US cohort study. This examination allowed us not only to evaluate the overall associations but also to assess in depth these associations with sufficient power in potentially interesting subgroups."

Study participants were enrolled in the Health Professionals Follow-Up Study and were 46 to 81 years old in 1992. In that year and biennially thereafter, the men reported on whether they had surgery for enlarged prostate. In 1992 and on 3 subsequent questionnaires, they also completed the American Urological Association symptom index (AUASI).

Cases of benign prostatic hyperplasia were defined as men who reported having surgery or who had an AUASI score of 15 to 35 (n = 6092). Control subjects were men who had not had surgery and never had an AUASI score of more than 7 (n = 18,373). Men with a score of 8 to 14 (n = 7800) were excluded from analysis. A food-frequency questionnaire was administered in 1986 to evaluate intakes of fruit, vegetables, and antioxidants.

Although vegetable intake was inversely associated with BPH (fifth compared with first quintile — odds ratio [OR], 0.89; 95% confidence interval [CI], 0.80 - 0.99; P for trend = 0.03), fruit intake was not. Consumption of fruit and vegetables rich in beta-carotene (P for trend = .004), lutein (P for trend = .0004), or vitamin C (P for trend = .05) was inversely related to BPH.

With increasing dietary vitamin C consumption, risk for BPH decreased (P for trend = .0009). Neither alpha- nor gamma-tocopherol intake from foods was associated with BPH (P for trend = .05 and .84, respectively).

"Our findings are consistent with the hypothesis that a diet rich in vegetables and in beta-carotene, lutein, and vitamin C derived from foods may reduce the occurrence of BPH," the authors write. "Although we observed inverse associations among several aspects of diet of middle-aged men, it might be more important to examine diet during the time period of BPH initiation, especially in the context of BPH prevention. However, our work may be informative about the role of modifiable factors in the progression to symptomatic BPH."

The Public Health Service and the Department of Health and Human Services, the National Institutes of Health, supported this study. The authors have disclosed no relevant financial relationships.

BPH can be related to diet, as evidenced in a study by Suzuki and colleagues, which was published in the April 2002 issue of the American Journal of Clinical Nutrition. This assessment of men in the Health Professionals Follow-up Study found that total energy intake and consumption of protein were positively associated with the risk of developing BPH. Total fat intake did not correlate with the risk for BPH, although increased consumption of the polyunsaturated fatty acids increased this risk.

Other evidence has suggested that a diet rich in fruits and vegetables might reduce the risk for incident BPH. The current study revisits the research cohort from the Health Professionals Follow-up Study to address this question.

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