When men have trouble in the urination department, it’s usually because of BPH, says Kevin McVary, chair of the division of urology at the Southern Illinois University School of Medicine.
BPH (benign prostatic hyperplasia) is an enlarged prostate. It can pinch off the flow of urine, causing an increase in urinary urgency and frequency. It can also cause incontinence.
Before men resort to drugs or surgery, McVary suggests trying lifestyle changes.
“Some of the things you do for your heart are the same things you do for your prostate,” he says. “Lose weight, exercise, and don’t smoke. Pretty simple.”
McVary concedes that his prescription has never been tested in a clinical trial. “I’ve been trying unsuccessfully for years to persuade the National Institutes of Health to fund a project like this,” he says, “but they reply that no one is dying from an enlarged prostate.”
There is evidence, however, from studies that ask people about their weight and exercise habits, then follow them for years. The Health Professionals Follow-Up Study tracked more than 18,000 men for 22 years. Those who were overweight were 11 to 25 percent more likely to have urinary tract symptoms than those who weren’t. And those with a waist larger than 38 inches were 23 percent more likely than those with a waist smaller than 33 inches. (1)
Does losing weight improve symptoms, like it does in women?
“We don’t have direct evidence, but we do know that symptoms improve in men who have weight-loss surgery,” says McVary. “There’s also something about exercise that prevents the development or mitigates the level of symptoms,” he adds. “The guys who exercise seem to do better.”
When researchers looked at eight studies on more than 35,000 men, they reported that those who did regular moderate or heavy exercise were 26 percent less likely to develop lower urinary tract symptoms than sedentary men. Doing light physical activity didn’t help. (2)
Why does exercise matter? One possibility: “Men who exercise have lower levels of inflammation, which causes less prostate growth and less deposition of collagen in the bladder,” explains McVary. A fibrous bladder makes urinating more difficult.
The bottom line:
- Lose (or don’t gain) excess weight.
- Shoot for 30 to 60 minutes a day of moderate-to-vigorous exercise.
- Strengthen your pelvic muscles (men as well as women) with Kegel exercises. (See www.nutritionaction.com/kegels.)
(1) J. Urol. 191: 715, 2014.
(2) BJU Int. 115: 466, 2015.
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