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CME Released: 6/27/2006
Valid for credit through: 6/27/2007
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June 27, 2006 — Starch may increase the risk for benign prostatic hyperplasia (BPH), whereas polyunsaturated fatty acids may decrease the risk, according to further analysis of an Italian case-control study reported in the June issue of Urology.
"Although BPH is a major public health problem, causing high morbidity and substantial worsening in men's quality of life, little is known about its risk factors, including diet and other lifestyle habits," write Francesca Bravi, MD, from the Istituto di Ricerche Farmacologiche "Mario Negri" in Milan, Italy, and colleagues. "In particular, the potential role of specific macronutrients on BPH has received little attention. However, nutritional factors could be important by influencing hormonal concentrations implicated in prostatic enlargement."
This case-control study included 1369 patients with BPH and 1451 controls, who were admitted to the same hospitals for a wide spectrum of acute, nonneoplastic conditions. Using a validated and reproducible food frequency questionnaire, the investigators determined the subjects' usual diet, and they obtained multivariate odds ratios (ORs) and 95% confidence intervals (CIs) after allowance for energy intake and other potential confounding factors.
Starch intake was related directly to BPH (OR, 1.51; 95% CI, 1.15 - 1.99 for highest quintile compared with lowest one), and polyunsaturated fatty acids intake was related inversely (OR, 0.72; 95% CI, 0.55 - 0.93), as was intake of linoleic acid (OR, 0.73; 95% CI, 0.56 - 0.94) and linolenic acid (OR, 0.71; 95% CI, 0.54 - 0.93).
Study limitations include the absence of a clear case definition of BPH, possible misclassification of controls, and difficulty in assessing long-term dietary patterns.
"The results of this study suggest a role for specific macronutrients in the risk of BPH, including, in particular, an unfavorable effect for starch and a beneficial one for polyunsaturated fatty acids," the authors write. "The issue of BPH and diet, however, remains open to discussion, given the inconsistencies of our results with those of a few previous investigations.
The Italian Association for Cancer Research and the Italian League Against Cancer, Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Pordenone; Servizio di Epidemiologia, Istituto Tumori "Fondazione Pascale," Naples; Servizio Integrato di Epidemiologia e Sistemi Informativi, Istituto "Regina Elena," Rome, Italy; International Agency for Research on Cancer, Lyon, France; and Istituto di Statistica Medica e Biometria,Università degli Studi di Milano, Milan, Italy, supported this study.
Urology. 2006;67:1205-1211
