Eat your way to a healthy prostate
In this age of globalization when fast-food chains and saturated fat reign supreme, Asian men can no longer remain complacent. Awi Curameng, M.D. reveals the menu for a healthy prostate gland.

The average Asian man will likely be unable to point to his prostate gland if asked to, let alone know how to take good care of it. The prostate gland is a walnut-shaped organ at the base of the penis that secretes fluid that nourishes the sperm in semen.

It's not simply a case of out-of-sight, out-of-mind. For decades, the prostate cancer rate of Asian males has been very low compared with their Western counterparts, fostering a collective ignorance that, though undesirable in the context of today's prevailing health consciousness, didn't seem to do anyone much harm either.

Interestingly, the key did not seem to be genetics but lifestyle. "The theory is that the risk of prostate cancer [is closely associated] with the dietary habits of men in different countries and societies," says Dr. JV Prodigalidad, attending urologist at the Makati Medical Center in Manila.

"Since for many years the disease has been most frequent in Western regions-the United States, the United Kingdom and Scandinavia-the hypothesis was that a fatty diet is associated with its development. The reverse was true, at that time, for Oriental countries, where the diet consisted mostly of rice, vegetables and fish."

According to recent surveys, prostate cancer is up to 15 times more common in the U.S. than in many parts of Asia. "In a large Swedish study involving over 50,000 men, investigators discovered that the individuals who had the most intake of red meat and dairy products had the highest risk for metastatic prostate cancer," Prodigalidad says.

Of course, such dietary nuances do not hold true anymore in this age of globalization and consumerist culture, when fast-food chains and saturated fat hold undeniable sway worldwide. Consequently, the Asian male has become increasingly vulnerable to the many diseases associated with high-fat diets, cancer of the prostate being one of them. Migration studies conducted on Asian immigrants to the U.S. show the risk of their developing prostate cancer rising to levels comparable to Americans the longer they stay in their adopted country. Clearly, the Asian male can no longer afford to remain unmindful or complacent.

Given that factors such as diet and lifestyle play such an important part in the development of prostate disease, it stands to reason that positive changes in diet and lifestyle would be crucial in diminishing prostate cancer risk.

"People often underestimate the significance of what they eat to maintenance of overall health," says family physician Dr. Manuel Carrera. "Improvements in diet and activity are very often sufficient to stop chronic illnesses from evolving."

What's even more exciting is that "... in recent years, attention has focused on the role of nutrients as preventive agents [for cancer]," writes Dr. Nagi Kumar of the University of South Florida-H. Lee Moffitt Cancer Center and Research Institute in Cancer Control. "Basic research has identified certain nutrients as agents that inhibit mutagenesis and hyperproliferation," or the unchecked genetic modification and growth characteristic of cancer cells.

Though some authorities caution against prescribing these nutrients pending more exhaustive research on their safety profiles and the establishment of clearer guidelines for their use, Carrera advises his male patients to include them in their diets. "There is enough empirical evidence on the benefits of these substances to recommend their regular intake."

Many of his male patients "have issues with illness and loss of control," Carrera continues. "Asking these fellows to make proactive lifestyle changes like eating a healthier diet and engaging in a regular exercise program helps them to feel in control of their bodies and their selves, and this does more to keep them healthy than any drug or supplement."

If avoiding a high-fat diet helps to prevent prostate disease, what then should one eat to keep the prostate healthy? The latest scientific data strongly supports regular servings of tomato-based food, broccoli and similar vegetables, soy products, and antioxidants like vitamin E and selenium as crucial factors in maintaining prostate health.

TOMATO IS THE WAY TO GO
In a March 2002 article for the Journal of the National Cancer Institute, Dr. Edward Giovannucci and his colleagues presented study results showing a 20-percent reduction of prostate cancer risk in men who ate two or more servings of tomato sauce a week. Mainstream thinking currently attributes this protective effect to the substance lycopene, a phytochemical with powerful antioxidant properties that is found in high quantity in cooked or processed tomatoes.

"Lycopene is apparently taken up preferentially by prostate tissue, where it causes a reduction in the oxidative DNA damage caused by free radicals in the blood," Prodigalidad explains. These DNA changes are among the major tissue transformations that eventually lead to cancer development.

A healthy prostate requires: one serving of tomato-based food daily, either as fresh tomato, juice, soups or sauces. (A serving of fruits and vegetables is approximately half a cup). A recent Harvard study found that men who ate 6.5 milligrams of tomato per day, or about 10 servings per week, had the most protection against cancer.

BRING ON THE BROCCOLI
Another phytochemical with amazing cancer-fighting effects is 3,3'-diindolylmethane, or DIM. Research published last year by scientists from the University of California in Berkeley labeled DIM -- obtained by eating cruciferous vegetables like broccoli, Brussels sprouts and cauliflower -- as a potent antiandrogen that inhibits the growth of human prostate cancer cells in culture. Androgens like the male hormone testosterone play a key role in the early development of prostate cancer.

A healthy prostate requires: five or more servings of cruciferous and other veggies a day. Broccoli is likewise a rich source of vitamins A and C.

SOY IS THE PROSTATE'S JOY
Food made from soybeans -- soy-milk products, tofu, soy sauce and miso -- are the only sources of nutritionally significant amounts of the phytochemicals known as isoflavones, which, like DIM, have been shown to slow the growth of prostate cancer cells in laboratory cultures.

Isoflavones, like the substances genistein and daidzein, alter the metabolism of androgens so that their impact on target tissues like the prostate is lessened; as a result, the tendency for cancer cells to proliferate is diminished. The soy-rich diet of many Asian countries is hypothesized to be an important element contributing to the region's low prostate cancer incidence rates.

A healthy prostate requires: 35 grams to 40 grams of soy products daily (for instance, a serving of tofu), according to published recommendations of the Louis Warschaw Prostate Cancer Center of the Cedars-Sinai Medical Center in Los Angeles. There is also substantial evidence that isoflavones protect against heart disease.

VITAMINS FOR THE HEALTHY MAN
In a 1998 Finnish lung cancer trial involving 29,000 smokers, vitamin E was found to have only a minimal effect on lung cancer occurrence, but investigators analyzing other conditions of the study participants found a remarkable 32-percent reduction in prostate cancer occurrence. Similarly, when selenium was being studied in 1996 as a possible factor in reducing skin cancer incidence, investigators were surprised to discover an associated 66-percent reduction in prostate cancer incidence in their selenium-treated patients.

Like lycopene, both selenium and vitamin E are powerful antioxidants believed to play a role in controlling free radical-caused cell damage that can lead to prostate cancer development. Selenium is a nonmetallic trace element that is found in many foods and water, but most especially in seafood, meats and Brazil nuts. Vitamin E is found in large amounts in green leafy vegetables, vegetable oils, nuts and egg yolk.

A healthy prostate requires: at least 55 micrograms of selenium daily, and 15 milligrams of vitamin E. Though commercially popular multivitamin supplement brands contain proper amounts of these two substances, nutritionists will insist that getting one's daily antioxidant dose from food in a balanced diet -- being more easily absorbed by the body -- is always the preferred option.