Scientific Review Links Med Diet Adherence With Improved Urological Health

A major review pub­lished in BMC Urology has shown pos­i­tive links between adher­ence to the Mediterranean diet and improved uro­log­i­cal health and sex­ual func­tion in both men and women.

The researchers found com­pelling evi­dence sug­gest­ing that the Mediterranean diet may sig­nif­i­cantly pre­vent and alle­vi­ate a range of uro­log­i­cal ail­ments and con­di­tions.

The Mediterranean diet pri­or­i­tizes whole grains, legumes, fruits, veg­eta­bles and extra vir­gin olive oil while min­i­miz­ing red meat and processed foods.

Scientifically rec­og­nized for its numer­ous health ben­e­fits, the Mediterranean diet remains under-explored con­cern­ing its impact on uro­logic con­di­tions such as sex­ual dys­func­tion, uri­nary symp­toms, stone dis­ease and uro­logic can­cers.

A sys­tem­atic review of 955 sci­en­tific papers revealed that adopt­ing a Mediterranean diet can effec­tively pre­vent and improve con­di­tions like erec­tile dys­func­tion, nephrolithi­a­sis, lower uri­nary tract symp­toms and uri­nary incon­ti­nence.

The preva­lence of uro­logic con­di­tions like erec­tile dys­func­tion, hypog­o­nadism, benign pro­sta­tic hyper­pla­sia, lower uri­nary tract symp­toms, uri­nary incon­ti­nence and nephrolithi­a­sis is ris­ing, often linked with med­ical comor­bidi­ties such as obe­sity, hyper­lipi­demia, hyper­ten­sion, dia­betes mel­li­tus and heart dis­ease.

Mediterranean diet mit­i­gates sex­ual dys­func­tion

Cross-sec­tional stud­ies indi­cate a lower preva­lence of erec­tile dys­func­tion among those adher­ing to the Mediterranean diet, sug­gest­ing its poten­tial in mit­i­gat­ing uro­logic con­di­tions.

Moreover, dietary inter­ven­tions may influ­ence testos­terone lev­els and fer­til­ity, although fur­ther research is war­ranted.

Multimodal treat­ment approaches, incor­po­rat­ing lifestyle mod­i­fi­ca­tions like dietary changes and increased phys­i­cal activ­ity, hold promise in man­ag­ing uro­logic con­di­tions, as guide­lines from orga­ni­za­tions like the American Urological Association rec­om­mend.

Evidence sug­gests that adher­ence to a Mediterranean diet may also improve female sex­ual dys­func­tion inci­dence and symp­toms, akin to its effect on male sex­ual dys­func­tion.

The MEDITA trial observed a reduced risk of new female sex­ual dys­func­tion inci­dence and wors­en­ing symp­toms among adher­ents com­pared to a low-fat diet. However, the tri­al’s applic­a­bil­ity to the gen­eral pop­u­la­tion is lim­ited as all par­tic­i­pants had dia­betes at base­line.

Clinical tri­als assess­ing the Mediterranean diet’s impact on women with meta­bolic syn­drome revealed sig­nif­i­cant improve­ments in female sex­ual func­tion scores over two years, con­trast­ing with min­i­mal changes in the con­trol group.

Cross-sec­tional stud­ies also indi­cate a lower female sex­ual dys­func­tion preva­lence among women adher­ing to the diet, albeit con­founded by fac­tors like BMI and depres­sion.

While the exact mech­a­nisms under­ly­ing the Mediterranean diet’s ben­e­fits for female sex­ual dys­func­tion remain unclear, hypothe­ses include its anti-inflam­ma­tory and antiox­i­dant prop­er­ties.

Female sex­ual dys­func­tion is mul­ti­fac­to­r­ial, influ­enced by psy­cho­log­i­cal and phys­i­o­log­i­cal fac­tors, neces­si­tat­ing a mul­ti­dis­ci­pli­nary approach along­side dietary inter­ven­tions.

Overall, the diet’s poten­tial ben­e­fits for sex­ual dys­func­tion align with its role in main­tain­ing healthy body weight, reduc­ing sat­u­rated fat intake and alle­vi­at­ing inflam­ma­tory stress.

Mediterranean diet adher­ence ben­e­fits uri­nary tract and prostate health

While sci­en­tific research on the diet’s effect on lower uri­nary tract symp­toms and benign pro­sta­tic hyper­pla­sia is lim­ited, some stud­ies sug­gest poten­tial ben­e­fits.

In the Health Professionals Follow-Up Study, higher intake of veg­eta­bles, β‑carotene and lutein was asso­ci­ated with reduced inci­dence of lower uri­nary tract and benign pro­sta­tic hyper­pla­sia, indi­cat­ing a poten­tial util­ity.

However, men with mod­er­ate benign pro­sta­tic hyper­pla­sia symp­toms were excluded from the analy­sis, lim­it­ing insights for this group.

In the Prostate Cancer Prevention Trial placebo arm, higher total fat con­sump­tion cor­re­lated with increased benign pro­sta­tic hyper­pla­sia risk, while fre­quent veg­etable con­sump­tion reduced the risk.

Interestingly, dietary fac­tors like polyun­sat­u­rated fat intake were asso­ci­ated with increased benign pro­sta­tic hyper­pla­sia risk, sug­gest­ing com­plex inter­ac­tions.

These find­ings imply that a Mediterranean diet, rich in veg­eta­bles and pro­tein while low in total fat, may mit­i­gate lower uri­nary tract and benign pro­sta­tic hyper­pla­sia risk, empha­siz­ing the impor­tance of dietary choices in man­ag­ing these con­di­tions.

Antioxidants in MedDiet may improve out­comes for uri­nary incon­ti­nence

While stud­ies pri­mar­ily focus on weight loss ben­e­fits for uri­nary incon­ti­nence, a few sug­gest addi­tional advan­tages from dietary fac­tors.

For men with prostate can­cer, higher veg­etable intake improved uri­nary incon­ti­nence, while increased polyun­sat­u­rated and monoun­sat­u­rated fat con­sump­tion wors­ened it.

A cross-sec­tional study on women found high sat­u­rated fat intake cor­re­lated with increased uri­nary incon­ti­nence risk, while increased car­bo­hy­drate and sugar intake reduced it.

Additionally, high total fat intake cor­re­lated with stress uri­nary incon­ti­nence risk in women over 40. Diets induc­ing inflam­ma­tion, such as the Western diet, are asso­ci­ated with urgency uri­nary incon­ti­nence.

Although the Mediterranean diet’s direct impact on incon­ti­nence is under­ex­plored, evi­dence sug­gests its poten­tial ben­e­fits, espe­cially for stress and urgency uri­nary incon­ti­nence, due to lower sat­u­rated fats and higher veg­etable and antiox­i­dant con­tent.

The com­plex rela­tion­ship between the Med Diet and stone dis­eases

Diet plays a sig­nif­i­cant role in stone dis­ease due to var­i­ous meta­bolic risk fac­tors. Higher body mass index (BMI) and insulin resis­tance in type 2 dia­betes patients increase nephrolithi­a­sis risk, par­tic­u­larly for uric acid stones.

The Mediterranean diet reduces stone for­ma­tion risk, as evi­denced by cohort stud­ies show­ing decreased inci­dence with Mediterranean diet adher­ence.

However, some stud­ies con­tra­dict this, not­ing stone for­m­ers con­sume less olive oil and that spe­cific dietary fat con­tent may affect stone risk.

The Mediterranean diet’s mech­a­nism involves uri­nary alka­liza­tion from fruit intake and increased uri­nary cit­rate, mag­ne­sium and phy­tate in whole grains, which inhibit stone for­ma­tion.

Still, oxalate-rich foods like almonds and spinach may pose a risk. The DASH diet, sim­i­lar to the Mediterranean diet but with lower sodium, also reduces stone risk.

However, sodium restric­tion and low ani­mal pro­tein intake are advised for hyper­cal­ci­uric stone for­m­ers, and tri­als show­ing reduced uri­nary cal­cium lev­els with­out increas­ing oxalate excre­tion sup­port this.

Associations between Mediterranean diet and prostate can­cer

Research exten­sively explores diet’s role in prostate can­cer, assess­ing both risk and prog­no­sis post-diag­no­sis.

A piv­otal 2005 study from the University of California – San Francisco indi­cated that inten­sive lifestyle changes might influ­ence prostate can­cer pro­gres­sion.

Patients on active sur­veil­lance who con­sumed a diet rich in fruits, veg­eta­bles, whole grains and soy, and reg­u­lar mod­er­ate aer­o­bic exer­cise expe­ri­enced decreased prostate-spe­cific anti­gen lev­els, sug­gest­ing poten­tial ben­e­fits for active sur­veil­lance patients. However, mea­sur­ing prostate-spe­cific anti­gen kinet­ics alone may not fully cap­ture prostate can­cer pro­gres­sion.

The spe­cific impact of a Mediterranean diet on prostate can­cer remains uncer­tain. While the Health Professionals Follow-up Study found no link between the Mediterranean diet and advanced prostate can­cer risk, men with higher Mediterranean diet adher­ence post-diag­no­sis showed reduced mor­tal­ity risk.

Notably, those adher­ing to the diet often exhib­ited health­ier lifestyles over­all. Some stud­ies sug­gest olive oil and cer­tain nutri­ents like vit­a­min E, vit­a­min C, sele­nium and lycopene may con­fer ben­e­fits, but results are incon­sis­tent.

Overall, evi­dence regard­ing diet’s influ­ence on prostate can­cer remains incon­clu­sive, neces­si­tat­ing fur­ther inves­ti­ga­tion despite indi­ca­tions of poten­tial ben­e­fits for men with low-risk dis­ease under active sur­veil­lance.

Evidence sug­gests an asso­ci­a­tion between Med Diet and a lower risk of blad­der can­cer

The effec­tive­ness of a Mediterranean diet in pre­vent­ing blad­der can­cer also presents mixed find­ings.

The European Prospective Investigation into Cancer and Nutrition (EPIC) study, involv­ing 477,312 par­tic­i­pants across Europe, noted a poten­tially reduced risk of blad­der can­cer with Mediterranean diet adher­ence, albeit sta­tis­ti­cally insignif­i­cant.

Notably, cur­rent smok­ers, par­tic­u­larly heavy and long-term smok­ers, showed a decreased risk, pos­si­bly due to the Mediterranean diet’s high antiox­i­dant con­tent coun­ter­act­ing smok­ing-induced DNA dam­age.

Another case-con­trol study high­lighted a neg­a­tive asso­ci­a­tion, indi­cat­ing a lower risk with higher Mediterranean diet adher­ence.

This study specif­i­cally empha­sized the ben­e­fits of legumes, veg­eta­bles and fish for their anti-inflam­ma­tory prop­er­ties. However, it lacked a con­trol group for phys­i­cal activ­ity, a known pro­tec­tive fac­tor for blad­der can­cer.

A meta-analy­sis of 13 prospec­tive cohort stud­ies rein­forced these find­ings, sug­gest­ing a reduced risk of blad­der can­cer with high Mediterranean diet adher­ence, poten­tially linked to increased olive oil intake and polyphe­nols coun­ter­ing inflam­ma­tion and oxida­tive stress, par­tic­u­larly from smok­ing.

Despite these promis­ing indi­ca­tions, fur­ther research is needed to com­pre­hen­sively under­stand the diet’s impact on blad­der can­cer risk.

Mediterranean diet adher­ence may lower risk of renal can­cer

Limited lit­er­a­ture exists on the long-term effects of a Mediterranean diet on renal can­cer risk.

However, obe­sity is linked to its devel­op­ment due to increased inflam­ma­tory stress and insulin resis­tance, which pro­mote cel­lu­lar pro­lif­er­a­tion and inhibit apop­to­sis (cell death), favor­ing tumor for­ma­tion. Meta-analy­ses have shown that higher BMI cor­re­lates with increased rel­a­tive risk for renal car­ci­noma.

While many sources val­i­date the asso­ci­a­tion between obe­sity and renal can­cer, lon­gi­tu­di­nal prospec­tive analy­ses assess­ing the Mediterranean diet as a pre­ven­tion strat­egy are scarce.

Case-con­trol stud­ies in Mediterranean coun­tries sug­gest that diets rich in olive oil, veg­eta­bles, whole grains, and fish may reduce the inci­dence of renal can­cer.

For instance, a high intake of cooked veg­eta­bles and poul­try and a low intake of processed meat are asso­ci­ated with reduced risk, while high bread intake is linked to ele­vated risk.

The pres­ence of unsat­u­rated fatty acids in olive oil and fish, along with antiox­i­dants in veg­eta­bles, may con­tribute to this pro­tec­tive effect.

However, fur­ther research is nec­es­sary to ascer­tain the poten­tial of the Mediterranean diet in renal can­cer pre­ven­tion com­pared to antiox­i­dant-rich diets.

• Physicians Weekly