So we've covered what the prostate is, what it does and what can happen to it. Now the question we need to answer is "How can I help that little guy out?" There are a number of things that a man can do and it primarily comes down to what we put in our mouths and how much we move our bodies.
Feed your prostate plants
Research has shown that cutting out meats and dairy, while substituting them with plants, can help control the hormonal situation leading to BPH. Eating meat daily triples the risk of prostate enlargement, regular milk consumption doubles the risk and not eating vegetables nearly quadruples the risk. While there is good evidence to suggest vegetables help, the same cannot be said for fruit (however, fruit has so many other benefits it's silly not to eat it).
Why does this work? I think people will assume that eating a plant-based diet reduces testosterone, which reduces the conversion to DHT, which will result in less prostate cell growth. Made sense to me, but certain research shows that vegan men actually have higher levels of testosterone (but it should be noted that other research demonstrates reduced androgen (testosterone) levels in vegetarian men). What else could it be? The first paper also showed that a plant-based diet reduced levels of IGF1 (Insulin-like growth factor 1, which plays an important role in growth and anabolic processes) while increasing SHBG (Sex hormone binding globulin, which facilitates transport and inhibits androgens (testosterone) and estrogens) and IGF1-binding protein. These two factors may be contributing to reducing prostate cell growth and reducing BPH (and preventing prostate cancer).
Evidence is still unclear as to what the exact mechanism is, but most research is in agreement that for a healthy prostate, a plant-based diet is best. What are some foods to make sure we include and avoid? Include legumes (beans, peas, lentils, soy), garlic, onion and flax seeds while avoiding refined grains, eggs, dairy and meat.
Even if a plant-based diet is your thing, it still doesn't mean you're bullet-proof. It's important to maintain a healthy weight as increased calorie intake with weight gain (along with hypertension and associated metabolic disturbances like increased insulin levels) appear to increase the risk of BPH.
This DEFINITELY has an effect on prostate health. As noted above, if you keep your weight down (and hypertension, insulin levels) you can help maintain a healthy prostate. Some research has found that even a half hour of walking (combined with a plant-based diet) is enough to help slow BPH. What is it exactly about exercise that helps? There's lots that it does including improving cholesterol (HDL, LDL and total), decreases blood pressure, normalizes glucose levels, decreases sympathetic (your fight or flight) signal transduction, stabilizes androgens and reduces adipose tissues. There are so many reasons to get exercise, and this is just one more. It's awesome to see the Movember campaign this year include exercise as part of its mission as it is something that can help people everywhere in so many ways.
How else can we give our prostates some love? There's some great herbal options out there that can decrease symptomatic BPH and even decrease prostate volume.
Saw palmetto (Serenoa repens)
This anti-inflammatory herb is indicated in micturition (urinary) disorders and especially BPH. It blocks the conversion of testosterone to DHT by inhibiting 5-alpha-reductase. Some research has shown it can induce a 50% increase in urinary flow and a 45% decrease in nocturia (having to pee at night). So even though it has not been shown to decrease prostate volume, many men will appreciate its ability to reduce their symptoms.
Red Stinkwood (Pygeum africanum)
Another herb that helps with BPH but also aids in prostatitis. Pygeum has phytosterols that inhibit the production of pro-inflammatory prostaglandins to decrease inflammation. While increasing urinary flow and decreasing nocturia, it has also been shown to help reduce prostate volume when taking a pygeum extract (150mg/day).
Stinging Nettle (Urtica dioica)
One last herb that can help BPH is one that grows in abundance around Vancouver. Nettle works in the same way as Saw Palmetto- blocking 5-alpha-reductase and decreasing the testosterone to DHT conversion. Through doing this, nettle has been shown to help with urinary problems and create a modest reduction in prostate size over the course of treatment. Nettle is especially useful when combined with Saw Palmetto- the two herbs working together can cause a significant decrease in urinary problems while having less unpleasant side-effects than some drugs used to treat BPH/LUTS. Nettle has some other interesting actions which you can read about here and here, but it also makes for a delicious food that you can use like many of your other leafy greens (once you steam and take away the barbs).
To sum this all up is pretty straight forward- if you're concerned about prostate health you should eat mostly plants, get plenty of exercise and consider some herbal options for gentle and effective treatment. One other thing- it has been demonstrated that regular, moderate (!) alcohol intake has preventative effects on prostate health, so after you get some exercise and eat a delicious vegan meal, tip one back and say cheers to your prostate.