Plant-based or vegan diets predominantly include foods of plant origin, while plant-based (PF) or Mediterranean diets incorporate foods of animal origin, such as dairy products and meat, in smaller proportions than foods of plant origin. Factors driving the shift from plant-based to PF diets include improved health, animal welfare and environmental concerns. Plant-based diets are believed to protect against prostate hypertrophy (IPE), erectile dysfunction (DER) and prostate cancer (PRO), by regulating sex hormone levels, increasing nitric oxide level and improving disease-related comorbidities. However, the benefits of such diets in preventing and managing these medical conditions are unclear.
In a recent study published in the journal Urology, researchers in the United States performed a systematic review of existing data to see if PF diets could improve men’s health by preventing and managing these conditions. Databases such as Medline and PubMed were searched for articles on studies including human participants consuming plant-based or PF diets published between 1989 and 2022. In total, 346 records were initially identified, of which 121 with unmet eligibility criteria are were excluded, and the remaining 225 records were screened. After full text review, only 24 eligible publications were considered for final analysis.
A study involving 1,400 participants in the National Survey of Health and Nutrition (NHANES) reported that higher plant-based dietary index (hPDI) scores were associated with lower PSA levels. In the ProtecT case-control study involving 13,811 individuals, an inverse association was observed between the risk of developing PRO and PRO Dietary Index scores. Similarly, PF diets reduced the likelihood of developing prostate cancer. In a prospective cohort study including 14,000 individuals older than 25 years, assessments of diet using lifestyle questionnaires indicated that the risk of PRO was inversely associated with legume and tomato intake.
Consumption of the Mediterranean diet for two years was significantly associated with IIEF-5 scores above 21, indicative of resolution of erectile dysfunction symptoms, compared with controls (37% versus 6.7%, respectively). Among 2,549 NHANES participants aged 20 to 70, hPDI scores were inversely associated with erectile dysfunction risk. Among 2,820 Italian-resident males aged <75 years, BPH risks were inversely associated with consumption of legumes/legumes, citrus fruits, and cooked vegetables. Similarly, the risk of EPI was inversely associated with the intake of polyunsaturated fatty acids (omega-3 type), abundantly found in nuts and seeds.
This means that vegetables and legumes have carte blanche and, without exaggerating, the consumption of nuts can be useful at least to delay the onset of age-related prostate and erectile dysfunction problems.
- By Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Scientific publications
Feiertag N, Tawfik MM et al. Urology. 2023 March 22.
Stewart KL et al. Int J Mol Sci. 2023 Mar; 24(6):5486.
Russo GI et al. Nutrients 2021 Nov 19; 13(11):4148.