Could a Plant-Based Diet Benefit Men’s Health Below the Belt?

MIAMI — A plant-based or plant-forward diet may offer some protection against prostate cancer and other sexual health issues, according to a systematic review.

Twelve of the 23 studies that met the review’s inclusion criteria looked at prostate cancer, and data from large registry trials indicated a link between a plant-based diet and a decreased risk of incident prostate cancer, reported Nathan Feiertag, MD, a medical student at Albert Einstein College of Medicine in New York City, at the Sexual Medicine Society of North America (SMSNA) annual meeting.

“Medicine has moved to a more holistic approach overall, and with that, more researchers have started to look into [the question of] ‘Can we use these plant-based diets to help manage and prevent conditions like prostate cancer, erectile dysfunction [ED], and benign prostate hyperplasia [BPH]?’ Feiertag told MedPage Today. “There were relatively few studies that we were able to find for this literature review, but that’s the current state.”

As plant-based diets gain in popularity, more patients may be experimenting with them. Feiertag said that plant-based diets have shown health benefits for patients with diabetes and hypertension, but less is known about their benefits for prostate cancer, ED, and BPH.

Irwin Goldstein, MD, of the University of California San Diego, approached Feiertag after the presentation to invite him to submit the data to Sexual Medicine Reviews. Goldstein is the journal’s editor-in-chief.

“I need more information because to make a claim that a certain diet really positively affects the sexual function, that would be cool, but it needs to be real,” Goldstein told MedPage Today. “I would love to be in a position to say that there are pharmacologic strategies, surgical strategies, but maybe there are [also] just conservative, lifestyle changes [you could make for ED].”

Feiertag told MedPage Today that “Urologists can maybe consider our review as an opportunity to incorporate or modify existing diet counseling for their patients, especially the ones who are eager to implement lifestyle changes, particularly as it pertains to prostate hyperplasia, ED, and prostate cancer.”

The researchers evaluated mostly cohort studies, along with cross-sectional studies, and a small number of randomized, controlled trials. They included data from vegan diets, vegetarian diets, and plant-forward diets, such as the Mediterranean diet. Several small cohort studies showed a significant decrease in prostate cancer velocity, although the benefit was not sustained at 6 months, Feiertag stated.

Two of the five ED studies reviewed found an association between plant-based diets and improved International Index of Erectile Function scores, although one reported worsening scores. The two studies included on ED reported a reduced relative risk of ED for patients on plant-based diets. Five of six studies on BPH found plant-based diets were inversely related to developing BPH.

Feiertag and colleagues noted in the SMSNA abstract that the findings were not generalizable because the trials were limited to observational and cohort studies that relied on patient-reported evaluations of diet. They said more high-quality studies are needed to evaluate the relationship between diet and urological conditions.

However, no studies reported non-association or harmful effects of following a plant-based or plant-forward diet. “For the patients who want to change their diet, this is useful for them. It definitely won’t hurt,” Feiertag told MedPage Today.