title: Fruit and Vegetable Intake in Relation to Lower Urinary Tract Symptoms and Erectile Dysfunction Among Southern Chinese Elderly Men: A 4-Year Prospective Study of Mr OS Hong Kong.
abstract: The role of fruit and vegetable (FV) intake in relation to prostate health remains inconclusive. This 4-year longitudinal study aims to explore the association of FV intake and the development of lower urinary tract symptoms (LUTS, a cluster of chronic urinary symptoms occurring in bladder, prostate and urethra), incidence of symptomatic benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) in Chinese elderly men. Data were obtained from a 4 years longitudinal study (Mr OS Hong Kong, the largest prospective study on bone health in Chinese elderly). Two thousand Chinese men aged 65 years and older were recruited from the local community, of whom 1998 (99.9%) at baseline and 1564 (78.2%) at 4-year follow-up reported data on LUTS, which were evaluated by a validated International Prostate Symptoms Scale (IPSS). Erectile function was evaluated by the International Index of Erectile Dysfunction-5 (IIEF-5) questionnaires at 2- (n = 386) and 4-year (n = 475) follow-ups. Dietary intake was assessed using a validated food frequency questionnaire at baseline. Analysis was conducted using multivariate linear and logistic regression. For total FV and most of their subclasses, moderate consumption had the lowest mean changes of LUTS; we thus applied the moderate levels as the reference in the regression models. The high levels of total FV intake (>350  g/1000  kcal/day) were significantly associated with reduced IPSS by scores of -1.174 ± 0.459 (or -17.3% of basal IPSS, P = 0.011) relative to the moderate groups (250-350  g/1000  kcal/day). FV consumption had no significant association with the score change of ED or the odds of sexual activities at 4-year (all P > 0.05). High intake of dark and leafy vegetables (>50  g/1000  kcal/day) significantly reduced the risk of LUTS progression by 37.2% [odds ratio (OR) (95% confidence interval, 95% CI): 0.628 (0.466∼0.848), P = 0.002] or risk of symptomatic BPH by 34.3% [OR (95% CI): 0.657 (0.442-0.976), P = 0.038] after 4 years compared with the moderate group (25-50  g/1000  kcal/day). Adequate FV intakes, especially dark and leafy vegetables, were associated with improved LUTS among Chinese elderly men, but lack an association with ED and sexuality.
authors.affiliation: From the Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, Hong Kong SAR (Z-ML, CKMW, DC, BY, SY-SW); and Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, Hong Kong SAR (LAT).
authors.forename: Zhao-Min
authors.initials: ZM
authors.lastname: Liu
authors.forename: Carmen Ka Man
authors.initials: CKM
authors.lastname: Wong
authors.forename: Dicken
authors.initials: D
authors.lastname: Chan
authors.forename: Lap Ah
authors.initials: LA
authors.lastname: Tse
authors.forename: Benjamin
authors.initials: B
authors.lastname: Yip
authors.forename: Samuel Yeung-Shan
authors.initials: SY
authors.lastname: Wong
mesh_terms: D000368:Aged; D004032:Diet; D004034:Diet Surveys; D018450:Disease Progression; D007172:Erectile Dysfunction / Q000453:epidemiology*; D005638:Fruit; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000453:epidemiology*; D065840:Protective Factors; D012720:Severity of Illness Index; D014675:Vegetables
references.citation: N Engl J Med. 2012 Jul 19;367(3):248-57
references.pmid: 22808960
references.citation: Aging Male. 2010 Jun;13(2):113-9
references.pmid: 20429720
references.citation: J Hum Hypertens. 2007 Sep;21(9):717-28
references.pmid: 17443205
references.citation: Cell Mol Neurobiol. 2006 Jul-Aug;26(4-6):497-508
references.pmid: 16705481
references.citation: BMC Med Res Methodol. 2010 Apr 01;10:26
references.pmid: 20356408
references.citation: Urology. 2013 Dec;82(6):1330-5
references.pmid: 24295250
references.citation: Curr Opin Urol. 2011 Jan;21(1):1-4
references.pmid: 21045705
references.citation: Eur Urol. 2003 Nov;44(5):588-94
references.pmid: 14572759
references.citation: Eur Urol. 2015 Jun;67(6):1110-1111
references.pmid: 25840623
references.citation: Curr Urol Rep. 2009 Jul;10(4):279-86
references.pmid: 19570489
references.citation: Int J Impot Res. 2008 Dec;20 Suppl 3:S11-8
references.pmid: 19002119
references.citation: Urology. 1999 Aug;54(2):284-90
references.pmid: 10443726
references.citation: Am J Clin Nutr. 1996 Dec;64(6):850-5
references.pmid: 8942407
references.citation: Health Qual Life Outcomes. 2014 Jan 02;12:1
references.pmid: 24382363
references.citation: Recent Results Cancer Res. 2014;202:109-14
references.pmid: 24531784
references.citation: J Sex Med. 2009 Jul;6(7):2024-31
references.pmid: 19453871
references.citation: Aging Ment Health. 2009 May;13(3):376-82
references.pmid: 19484601
references.citation: Urology. 2006 Jan;67(1):73-9
references.pmid: 16413336
references.citation: J Nutr. 2006 Oct;136(10):2588-93
references.pmid: 16988131
references.citation: Prostate. 1983;4(3):253-64
references.pmid: 6189108
references.citation: Curr Opin Urol. 2014 Jan;24(1):3-9
references.pmid: 24280652
references.citation: J Clin Epidemiol. 1993 Feb;46(2):153-62
references.pmid: 8437031
references.citation: Am J Clin Nutr. 2002 Apr;75(4):689-97
references.pmid: 11916755
references.citation: BJU Int. 2006 Apr;97 Suppl 2:3-6; discussion 21-2
references.pmid: 16507045
references.citation: J Bone Miner Res. 1996 Sep;11(9):1364-8
references.pmid: 8864912
references.citation: Scand J Urol Nephrol. 2000 Feb;34(1):46-50
references.pmid: 10757270
references.citation: Lancet. 2006 Jan 28;367(9507):320-6
references.pmid: 16443039
references.citation: BJU Int. 2008 Mar;101 Suppl 3:17-21
references.pmid: 18307681
references.citation: J Urol. 1995 Nov;154(5):1770-4
references.pmid: 7563343
references.citation: Prostate. 1993;22(3):253-64
references.pmid: 7683816
references.citation: Am J Epidemiol. 2008 Apr 15;167(8):925-34
references.pmid: 18263602
references.citation: J Urol. 1992 Nov;148(5):1549-57; discussion 1564
references.pmid: 1279218
references.citation: Circulation. 2000 Oct 31;102(18):2284-99
references.pmid: 11056107
references.citation: Pharmacol Ther. 2010 May;126(2):159-72
references.pmid: 20171982
references.citation: Urology. 2014 Feb;83(2):411-5
references.pmid: 24246327
references.citation: Int J Impot Res. 2007 May-Jun;19(3):317-20
references.pmid: 17080093
references.citation: Int J Clin Pract. 2007 Dec;61(12):2019-25
references.pmid: 17997808
references.citation: BJU Int. 2011 Oct;108(7):1132-8
references.pmid: 21231991
references.citation: J Nutr. 2015 Jul;145(7):1464-71
references.pmid: 25972532
references.citation: Am J Clin Nutr. 1997 Apr;65(4 Suppl):1220S-1228S; discussion 1229S-1231S
references.pmid: 9094926
references.citation: Eur Urol. 2011 Jul;60(1):106-17
references.pmid: 21497433
references.citation: Urology. 1997 Jun;49(6):822-30
references.pmid: 9187685
references.citation: Am J Clin Nutr. 2007 Feb;85(2):523-9
references.pmid: 17284753