Effectiveness of a Very Low Calorie Ketogenic Diet on Testicular Function in Overweight/Obese Men.

BACKGROUND: Obesity has become an increasingly worrisome reality. A very-low-calorie ketogenic diet (VLCKD) represents a promising option by which to achieve significant weight loss. This study sought to evaluate the effectiveness of VLCKD on metabolic parameters and hormonal profiles of obese male patients. METHODS: We enrolled 40 overweight/obese men who consumed VLCKD for at least eight weeks. Body weight, waist circumference, fasting glucose, insulin, total cholesterol, high-density lipoprotein, triglycerides, creatinine, uric acid, aspartate aminotransferase, alanine aminotransferase, vitamin D, luteinizing hormone (LH), total testosterone (TT), and prostate-specific antigen (PSA) were calculated before and after VLCKD consumption. We additionally determined the homeostasis model assessment index and low-density lipoprotein (LDL) values. RESULTS: After VLCKD (13.5 ± 0.83 weeks), the mean body weight loss was 21.05 ± 1.44 kg; the glucose homeostasis and lipid profile were improved significantly; serum vitamin D, LH, and TT levels were increased and the PSA levels were decreased significantly as compared with pretreatment values. These results are of interest since obesity can lead to hypogonadism and in turn, testosterone deficiency is associated with impaired glucose homeostasis, metabolic syndrome, and diabetes mellitus. Moreover, a close relationship between obesity, insulin resistance, and/or hyperinsulinemia and increased prostate volume has been reported, with a consequent greater risk of developing lower urinary tract symptoms. CONCLUSIONS: VLCKD is an effective tool against obesity and could be a noninvasive, rapid, and valid means to treat obese patients with metabolic hypogonadism and lower urinary tract symptoms.

Impact of serum 25-OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder.

OBJECTIVES: To evaluate the impact of serum vitamin D level on male lower urinary tract symptoms (LUTS). PATIENTS AND METHODS: Men with LUTS who visited the outpatient clinic of the urology department at one of two hospitals between March 2014 and April 2017 were eligible for inclusion in the study. The impact of vitamin D on LUTS was evaluated using multivariate analysis to adjust for age, body mass index, prostate-specific antigen, testosterone, glycated haemoglobin, physical activity and prostate volume. To exclude the effect of seasons, we also analysed the impact during each season. RESULTS: Vitamin D level was lowest in winter. According to the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS), the severity of LUTS peaked in winter. There were no seasonal differences between prostate volume, maximum urinary flow rate (Qmax ) and post-void residual urine volume (PVR). For all patients, multivariate analysis showed that lower vitamin D level was significantly associated with higher total OABSS, whereas it was not associated with prostate volume, Qmax , PVR or total IPSS. In winter, lower vitamin D level was significantly associated with higher total OABSS based on multivariate analysis, whereas it was not during other seasons. In patients with vitamin D deficiency, the total OABSS significantly decreased after vitamin D replacement. The greatest improvement in total OABSS was associated with lower pre-treatment total OABSS and higher post-treatment vitamin D level. CONCLUSIONS: Vitamin D deficiency in men with LUTS may play a role in aggravated overactive bladder (OAB) symptoms, especially in winter. Increasing vitamin D level in patients with vitamin D deficiency appears to alleviate OAB symptoms.

Mediterranean diet after prostate cancer diagnosis and urinary and sexual functioning: The health professionals follow-up study.

BACKGROUND: Men with prostate cancer often experience urinary and sexual dysfunction after treatment. Previous studies have demonstrated a relationship between dietary factors and these symptoms among men with diabetes or metabolic syndrome. However, there are limited data on whether diet after prostate cancer diagnosis, including a Mediterranean dietary pattern, affects urinary and sexual function among prostate cancer survivors. METHODS: Men diagnosed with non-metastatic prostate cancer in the Health Professionals Follow-up Study (n = 2960) from 1986 to 2012 were prospectively followed for a median of 8.3 years after treatment. Participants completed validated dietary questionnaires every 4 years and a health-related quality of life assessment in 2010 or 2012. We used generalized linear models to examine associations between post-diagnosis Mediterranean Diet Score (including individual score components and dietary fat subtypes) and quality of life domains (sexual functioning, urinary irritation/obstruction, urinary incontinence) assessed using the Expanded Prostate Cancer Index Composite Short Form (score 0-100; higher scores indicate better function). RESULTS: No statistically significant relationships were observed between the Mediterranean Diet Score after prostate cancer diagnosis and urinary or sexual function. However, the associations did vary depending on pre-diagnosis urinary and sexual dysfunction for urinary irritation/obstruction and sexual function scores, respectively (P-interactions < 0.0001). Men with higher post-diagnosis vegetable intake reported higher urinary incontinence scores (72 vs 76 comparing lowest to highest quintile; P-trend = 0.003). Similarly, higher vegetable intake and lower polyunsaturated fat intake were associated with higher urinary irritation/obstruction scores (vegetable: 80 vs 84 comparing lowest to highest quintile, P-trend = 0.01; polyunsaturated fat: 84 vs 78 comparing lowest to highest quintile, P-trend = 0.005), however these associations were observed only among men with urinary symptoms prior to their prostate cancer diagnosis. CONCLUSIONS: Among men with prostate cancer, diet intake after diagnosis was not significantly associated with urinary or sexual function, although some relationships appeared to differ among men with and without symptoms prior to their prostate cancer diagnosis. Higher vegetable intake and lower polyunsaturated fat intake after prostate cancer diagnosis may be associated with better urinary function. However, this analysis was exploratory, and further research is needed to better delineate these relationships and guide dietary recommendations for men with prostate cancer.

Companion Animals Symposium: dietary management of feline lower urinary tract symptoms.

Experimental and clinical investigations have confirmed the importance of dietary modifications in medical protocols designed to treat and prevent feline lower urinary tract signs (LUTS). The objective of this review is to discuss common medical conditions contributing to feline LUTS and to present currently used and potential preventative dietary modifications. Feline LUTS are a set of clinical conditions with similar symptoms related to inappropriate urine elimination due to a combination of genetics, stress and frustration reactions, environment, and medical condition or conditions, for example, idiopathic cystitis, urolithiasis, urethral obstruction, and urinary tract infection. The main goals of dietary modifications to prevent LUTS are 1) promote large dilute volumes of urine, 2) decrease the relative supersaturation of urine for specific stone types, and 3) promote healthy bacterial populations in the gastrointestinal and urogenital tracts. The impact of dietary composition, including dietary moisture, protein concentration and digestibility, mineral concentrations (i.e., Na, Cl, Ca, P, and Mg), inclusion of acidifiers and alkalinizing agents, inclusion of vitamin B6, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and γ-linolenic acid, fiber concentration and characteristics, and oxalate degrading probiotics, on these outcomes is discussed, and dietary guidelines for cats are provided. Because of the complex interaction of diet composition, environment, and animal physiology, there is a need for clinical research linking current recommendations or dietary options for the treatment and prevention of LUTS with physiological outcomes (i.e., decreased relative supersaturation and LUTS recurrence). Additionally, for many recommendations (e.g., probiotic administration, EPA, DHA), extrapolation from other species was necessary. Research is needed in feline patients with LUTS on these dietary components.

Nutrition and benign prostatic hyperplasia.

PURPOSE OF REVIEW: Nutrition seems to modify the pathogenesis of benign prostatic hyperplasia (BPH) effect symptomology in men suffering from lower urinary tract symptoms (LUTS). Although there are numerous pharmaceuticals and procedures for these conditions, nutrition may improve outcomes as a primary approach or in tandem with BPH medications or procedures. The purpose of this review is to highlight the benefits of nutrition and dietary supplements in men with BPH and LUTS. RECENT FINDINGS: Dietary factors have an impact on metabolic disorders that lead to diabetes and obesity - both of which inversely effect BPH and LUTS. Dietary patterns associated with increased risks include starches and red meats, whereas moderate alcohol intake and polyunsaturated fat and vegetable consumption decrease risks. Dietary supplements of zinc, saw palmetto, and beta-sitosterol in relieving BPH symptoms have had mixed results. Randomized clinical trials of nutritional practices and other lifestyle alterations such as exercise for the prevention or treatment of BPH and LUTS have yet to be performed. SUMMARY: Nutritional practices may provide for the prevention and treatment of BPH and LUTS while positively affecting other systemic parameters. Whereas there are a few clinical randomized trials for the prevention and treatment of BPH and LUTS, nutritional modifications may have a healthy lifestyle alternative with minimal to no adverse effects.

A prospective randomized double-blind trial of grape juice antioxidants in men with lower urinary tract symptoms.

AIMS: Many patients take alternative medications for their lower urinary tract symptoms (LUTS) either in addition or as a substitute for traditional therapies, despite a lack of clinical data. Grapes products are hypothesized to improve bladder function due to their antioxidant and membrane-protective actions. There is increasing evidence that progression of obstructed bladder dysfunction is related to bladder ischemia, reperfusion injury and free radical damage. We prospectively studied a standardized grape product on urinary symptoms. METHODS: Men >45 years with significant LUTS were randomized to 240 ml daily of either 100% Concord grape juice or placebo. Participants were followed with validated questionnaires for LUTS, erectile dysfunction, and quality of life in addition to PSA, uroflow, and serum and urinary antioxidant levels. The primary endpoint was change in LUTS in Male International Continence Symptom score. The secondary endpoint was correlation between the level of antioxidants and changes in symptom scores. RESULTS: One hundred thirteen participations were randomized with 96 completing the 3-month follow-up. There was no difference in the primary endpoint between the groups. (ISCmale score improved by a mean of 1.6 points in both groups.) There was no statistical difference between groups by PSA or secondary questionnaires. A statistical significance was found between uroflow rates. Linear regression analysis gave no correlation between antioxidants (serum or urine) and changes in symptom scores or grape juice consumption. CONCLUSIONS: Our study did not demonstrate any difference in LUTS in men taking a daily 240 ml 100% grape juice versus placebo after 3 months.