Already at the age of 60, 50 percent of men suffer from prostatic hyperplasia and the prevalence of the disease progressively increases up to 90 percent of octogenarians. Prostatic hyperplasia is due to increased proliferation of prostate cells (both glandular epithelial cells and connective tissue cells) associated with hypertonicity of smooth muscle cells in the prostatic area surrounding the urethra. Those affected must get up several times at night to pee and sometimes must resort to a catheter to empty the bladder, because the prostate is too large and the muscle contraction squeezes the urethra and makes urination difficult.
Male hormones are not the cause of the disease
Male hormones (testosterone and its most potent metabolite, dihydrotestosterone) are required for prostate cell proliferation, but oddly enough, prostatic hyperplasia increases just as testosterone decreases with age. There is no correlation between prostate volume and plasma testosterone levels, and administration of male hormones does not increase prostate volume. Male hormones are necessary for the development of the disease (treatment with inhibitors of alpha-reductase, the enzyme that transforms testosterone into dihydrotestosterone, reduces symptoms), but they are not the cause of hyperplasia. The causes are elsewhere.
No to excessive protein consumption
Multiple studies have found that men with prostatic hyperplasia have higher blood insulin levels and are more likely to have metabolic syndrome, also called insulin resistance syndrome, characterized by abdominal adiposity, high blood pressure, hyperglycemia, and dyslipidemia (high triglycerides and cholesterol “good” low HDL). Metabolic syndrome favors diabetes and diabetics tend to have enlarged prostates. High plasma levels of IGF-1 — the growth hormone product that stimulates cell proliferation, the same growth factor that makes children grow — are associated with a two-fold risk of prostatic hyperplasia. Insulin increases IGF-1 by stimulating the synthesis of growth hormone receptors, but the main factor that causes IGF-1 to rise is the excessive protein consumption of our western civilization. And of all the proteins, the most effective are those of milk, a food for growth.
Yes to vegetables
The prospective study of US health care workers finds an increasing risk of prostatic hyperplasia with increasing protein consumption (up to 33 percent more), higher for animal than plant protein. Oddly (and inexplicably), however, only highly polyunsaturated omega-6 and omega-3 fats appear to be associated with risk. Another large American study does not find a risk from total proteins, which are indeed associated with a slightly lower risk, but only from a high consumption of red meat (7 or more portions a week), while vegetables protect. No studies have published results specific to milk consumption, but dairy products as a whole do not appear to be associated with increased risk. However, it is advisable that older men do not consume milk and dairy products, because many studies have found that these foods are associated with prostate cancer.
Beware of stress and high blood pressure
The prostate is rich in smooth muscle fibers and we have seen how the hypertonicity of these fibers, which are innervated by the sympathetic nervous system, compresses the urethra and hinders urination. The stress hormone norepinephrine is suspected to contribute to prostatic hypertrophy by stimulating muscle cell proliferation and contraction. The same hormone activates the renin-angiotensin system, which causes high blood pressure. Angiotensin stimulates the proliferation and tone of smooth muscle cells in both the arteries and the prostate. The size of the prostate, in fact, is also related to blood pressure: the higher the pressure, the larger the prostate. Hypertensives are 50 percent more likely to develop symptoms of prostatic hyperplasia than normotensives.
Foods to avoid
Prostatic hyperplasia and hypertension appear to be an inevitable consequence of aging in industrialized societies. Studies of people still living as hunter-gatherers show that they have very few urination problems and that their prostates are smaller, about half that of Britons and Americans of the same age. Blood pressure is also lower in these peoples, as are all the diseases of civilization (obesity, diabetes, heart disease). Insulin is also low, at least until these peoples are acculturated (as they often were forced to). In conclusion, let’s avoid foods that raise insulin: sugar, milk and refined flours and all the industrial junk that contains them in quantity.
*Doctor, former director of the Department of Preventive and Predictive Medicine of the Cancer Institute of Milan and founder of the La Grande Via association
2023-08-25 05:23:35
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