Scientific Review Links Med Diet Adherence With Improved Urological Health

Researchers reviewed almost 1,000 studies to determine the associations between following the Mediterranean diet and improved urological and sexual health outcomes.
By Simon Roots
Apr. 30, 2024 16:23 UTC

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.

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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.

See Also:Men’s Sexual Health May Benefit From Daily Nut Consumption and MedDiet

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.

See Also:Mediterranean Diet Decreases DNA Damage in Men with Prostate Cancer

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.

See Also:Olive Oil Offers Promising Role in Treatment of Bladder Cancer

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.


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