前列腺肥大不一定是老年病

最近看了一片研究文章，说是在流行病研究中发现在20世纪中国农村，得BPH的人很少！

同时，那时的中国农村人以粗粮和（几乎）素食为主。他们的糖尿病也很少。

这给出了BPH 和二型糖尿病（T2D）的关联。因而他们认为，BPH，如同T2D，是个代谢性疾病。

既然是代谢性疾病，那么饮食/生活方式就是根源。

请看这篇文章的Abstract 和 Conclusions:

 

Abstract:（饮食 + 生活方式 + 保健品）策略

Although benign prostatic hyperplasia (BPH) is often viewed as an inevitable concomitant of the aging process, recent research establishes that this syndrome is significantly more common in men with metabolic syndrome. Moreover, twentieth century epidemiology focusing on quasi-vegan rural China reveals that this syndrome may in fact be substantially preventable. The decline in cellular apoptosis which appears to be a key driver of BPH should be counteracted in part by diet/lifestyle measures which minimize systemic IGF-I activity. Diets moderate in protein and very low in animal products are associated with low plasma IGF-I levels, reflecting decreased hepatic production of this hormone. Leanness, exercise training, and other lifestyle measures which minimize diurnal insulin secretion, have been found to correlate with reduced BPH risk, and can be expected to reduce systemic and prostatic IGF-I/ IGF-II bioactivity by increasing hepatic secretion of IGFBP-1. Apoptosis of prostate cells can also be promoted by selective agonists for estrogen receptor-β; high dietary intakes of soy isoflavones can function as such agonists. Conversion of prostate epithelial and stromal cells to a myofibroblast phenotype by transforming growth factor-β contributes importantly to the expansion of the stromal compartment in BPH; there is reason to suspect that this transition could be opposed by the antioxidant activity of spirulina, AMPK-activating drugs or nutraceuticals, and possibly adiponectin (suggesting a further benefit of leanness). Although calcitriol analogs appear to have potential for preventing and treating BPH, there is no current evidence that dietary modulation of vitamin D status can be beneficial in this regard. Prospects for prevention of BPH may be good in individuals who adopt optimally healthprotective diet, lifestyle, and nutraceutical strategies. 

 

Conclusions: 饮食 (素食+适量蛋白+极少动物食品）+ 生活方式（减肥 +锻炼+低比率 饱和脂肪/不饱和脂肪+低血糖指数食品 + 多吃黃豆異黃酮?） + 保健品（drug: metaformin; nutraceutical: berberine)

In light of the twentieth century epidemiology of BPH in rural China and plentiful research linking BPH to metabolic syndrome, it can be concluded that BPH is not an inevitable concomitant of aging, but rather that it is substantially preventable via appropriate lifestyle measures. The considerations cited above suggest that a plant-based diet of moderate protein content, via down-regulation of serum IGF-I, may notably reduce BPH risk. Measures which minimize diurnal insulin secretion – such as leanness, exercise training, a low dietary saturate/ unsaturate ratio, [43] and low-glycemic-index food choices – may also reduce this risk by decreasing the effective activity of IGFs. Frequent consumption of soy isoflavones may promote apoptosis in prostate tissue by selective activation of ER-β. Spirulina (via PhyCB) and AMPK activators may have potential for suppressing the myofibroblast transdifferentiation that plays a pathogenic role in BPH. Although the calcitriol analog elocalcitol has been shown to slow prostate growth, it is not yet clear whether systemic vitamin D (serum levels of calcidiol or calcitriol) can have a meaningful influence in this regard. With respect to the low risk for BPH once enjoyed by rural Chinese, the above analysis suggests that a diet of modest protein content very low in animal products, leanness, regular physical activity and in some instances, a high intake of soy isoflavones, likely contributed to this protection. Although these suggestions are speculative at this time, it is reassuring to note that the diet/lifestyle/nutraceutical measures proposed are likely to be health protective in many other ways, and hence are recommendable whether or not they prove to be beneficial for BPH prevention. In particular, low IGF-I bioactivity, soy isoflavones, AMPK activators, leanness and physical activity may reduce risk for prostate cancer or aggressive prostate cancer [70-75] This essay has not discussed drugs or certain herbal extracts (such as saw palmetto or pygeum Africanum) often employed in the management of BPH because its intent was to focus on measures which are likely to have broad, rather than specialized, utility for health promotion.

https://www.hilarispublisher.com/open-access/dietlifestyle-strategies-for-preventing-benign-prostatic-hyperplasia-2167-0943.S1-e001.pdf