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Gupta N, Leapman MS, Loeb S. Plant-based diets, animal agriculture, and the connection with urological and planetary health. Curr Opin Urol 2024; 34:352-357. [PMID: 38832408 PMCID: PMC11303101 DOI: 10.1097/mou.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE OF REVIEW We summarize the latest evidence regarding the impact of plant-based diets on urological and planetary health to facilitate patient counseling and research regarding dietary intervention. RECENT FINDINGS Studies have highlighted the association of plant-based diets with a lower risk of multiple urological conditions including prostate cancer, erectile dysfunction, benign prostatic hyperplasia, and nephrolithiasis, as well as benefits for planetary health. SUMMARY Plant-based diets are associated with numerous benefits that co-promote urological and planetary health.
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Affiliation(s)
- Natasha Gupta
- Department of Urology, New York University, NY
- Department of Population Health, New York University, NY
- Department of Surgery/Urology, Manhattan Veterans Affairs, NY
| | | | - Stacy Loeb
- Department of Urology, New York University, NY
- Department of Population Health, New York University, NY
- Department of Surgery/Urology, Manhattan Veterans Affairs, NY
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Loeb S, Hua Q, Bauer SR, Kenfield SA, Morgans AK, Chan JM, Van Blarigan EL, Shreves AH, Mucci LA. Plant-based diet associated with better quality of life in prostate cancer survivors. Cancer 2024; 130:1618-1628. [PMID: 38348508 PMCID: PMC11009061 DOI: 10.1002/cncr.35172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Plant-based diets have many health benefits, including a lower risk of fatal prostate cancer, and greater environmental sustainability. However, less is known regarding the impact of plant-based diets on quality of life among individuals diagnosed with prostate cancer. The authors' objective was to examine the relationship between plant-based diet indices postdiagnosis with quality of life. METHODS This prospective cohort study included 3505 participants in the Health Professionals Follow-Up Study (1986-2016) with nonmetastatic prostate cancer. Food-frequency questionnaires were used to calculate overall and healthful plant-based diet indices. Quality-of-life scores were calculated using the Expanded Prostate Cancer Index Composite. Generalized estimating equations were used to examine associations over time between plant-based diet indices and quality-of-life domains (sexual functioning, urinary irritation/obstruction, urinary incontinence, bowel functioning, hormonal/vitality), adjusted for demographics, oncologic history, body mass index, caloric intake, health-related behaviors, and comorbidities. RESULTS The median age at prostate cancer diagnosis was 68 years; 48% of patients underwent radical prostatectomy, and 35% received radiation as primary therapy. The median time from diagnosis/treatment to first the quality-of-life questionnaire was 7.0 years. A higher plant-based diet index was associated with better scores for sexual function, urinary irritation/obstruction, urinary incontinence, and hormonal/vitality. Consuming more healthful plant-based foods was also associated with better sexual and bowel function, as well as urinary incontinence and hormonal/vitality scores in the age-adjusted analysis, but not in the multivariable analysis. CONCLUSIONS This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with modestly higher scores in quality-of-life domains among patients with prostate cancer.
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Affiliation(s)
- Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, New York, USA
| | - Qi Hua
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Scott R Bauer
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Stacey A Kenfield
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Alicia K Morgans
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - June M Chan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Alaina H Shreves
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- American Cancer Society, Atlanta, Georgia, USA
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Rosenfeld RM, Juszczak HM, Wong MA. Scoping review of the association of plant-based diet quality with health outcomes. Front Nutr 2023; 10:1211535. [PMID: 37637943 PMCID: PMC10447911 DOI: 10.3389/fnut.2023.1211535] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes. Methods Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI. Results We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI. Discussion Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.
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Affiliation(s)
- Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Feiertag N, Tawfik MM, Loloi J, Patel RD, Green B, Zhu M, Klyde D, Small AC, Watts KL. Should Men Eat More Plants? A Systematic Review of the Literature on the Effect of Plant-Forward Diets on Men's Health. Urology 2023; 176:7-15. [PMID: 36963667 DOI: 10.1016/j.urology.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE To perform a systematic review of the literature on plant-based and plant-forward diets and the prevention/treatment of the following common men's health conditions: prostate cancer (PCa), erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses system criteria were utilized to search PubMed and Medline databases for the following search terms: "Diet (Mesh)" OR "Diet Therapy (Mesh)" AND "Prostatic Hyperplasia (Mesh)" OR "Prostatic Neoplasm (Mesh)" OR "Erectile Dysfunction (Mesh)." Articles in English published from 1989 to 2022 using human participants were analyzed, data summarized, and assessed for bias. RESULTS Studies reporting on plant-based or vegetable-forward diets (Mediterranean) as an intervention were included. Cohort and cross-sectional studies using food frequency questionnaires or diet classification indices to quantify plant-based food intake patterns were included in the study. Ultimately, 12 PCa articles, 4 BPH articles, 6 ED articles, and 2 articles related to both BPH and ED were reviewed. Overall, the literature suggests plant-forward diets confer a protective effect on the men's health conditions reviewed. CONCLUSIONS Evaluation of the literature on the impact of plant-forward diets on urologic conditions includes a heterogenous range of dietary patterns and study designs. The greatest amount of research has evaluated the application of plant-forward diets for PCa. While there is currently a lack of high-quality evidence for the use of plant-forward diets as prevention and/or treatment for PCa, ED, or BPH, reported outcomes suggest a consistent small beneficial impact alongside well-established benefits for common chronic conditions.
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Affiliation(s)
| | | | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, NY
| | - Rutul D Patel
- Department of Urology, Montefiore Medical Center, Bronx, NY
| | | | - Michael Zhu
- Albert Einstein College of Medicine, Bronx, NY
| | | | - Alexander C Small
- Department of Urology, Montefiore Medical Center, Bronx, NY; Albert Einstein College of Medicine, Bronx, NY
| | - Kara L Watts
- Department of Urology, Montefiore Medical Center, Bronx, NY; Albert Einstein College of Medicine, Bronx, NY.
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Ruan Z, Xie X, Yu H, Liu R, Jing W, Lu T. Association between dietary inflammation and erectile dysfunction among US adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2001-2004. Front Nutr 2022; 9:930272. [PMID: 36438746 PMCID: PMC9691656 DOI: 10.3389/fnut.2022.930272] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although chronic low-grade inflammation has been linked to the development of erectile dysfunction (ED), the association between pro-inflammatory diets and ED is unclear. The dietary inflammation index (DII) is a novel method to quantify the inflammatory potential of a diet. OBJECTIVE Our objective was to investigate the association between the DII and ED among US males. DESIGN This cross-sectional study included 3,693 males 20-85 year of age from the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Multivariable-adjusted logistic regression models were used to assess the association between the DII and ED. All analyses accounted for the complex sampling design. RESULTS The mean ± SE of the DII was 0.8 ± 0.1 and 0.4 ± 0.1 among participants with and without ED, respectively. After adjusting for age, race/ethnicity, education, smoking status, physical activity, drinking status, hypertension, diabetes, cardiovascular disease, hypercholesterolemia, BMI, and eGFR, the DII score was associated with ED (odds ratio 1.12; 95% CI: 1.04-1.19). Moreover, this association was also stable in our subgroup analysis or sensitivity analyses. CONCLUSION Dietary inflammatory potential, as estimated by the DII score, is positively associated with ED among US males.
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Affiliation(s)
- Zhijie Ruan
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiaoping Xie
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Haoyang Yu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Ruimin Liu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Wenjuan Jing
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Tao Lu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
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