Men's health

Plant based foods are a good choice as part of a man’s healthy diet.

Evidence suggests that plant-based foods have specific cardiovascular and prostate health benefits.

Eating a plant based diet is a simple and easy way to look after your heart. Plant based foods such as fruit, vegetables, legumes, whole grains, nuts and seeds are lower in saturated fat and many are a source of fibre. A diet low in saturated fat is important for maintaining a healthy cholesterol level as part of a healthy balanced diet and lifestyle.

Plant foods such as almonds, hazelnuts, oats and soya have a specific cholesterol lowering effect. 

In the US the FDA has approved a heart health claim for both soya protein and nuts (almonds, hazelnuts). Soya foods can lower cholesterol in a number of ways. Nuts mainly contain unsaturated fats and very little saturated fats.

In Europe the blood cholesterol lowering effect of beta-glucans from oat and barley has also been recognized.

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A. Prevalence

Prostate cancer is the most common cancer among men in Europe with an estimated incidence of approximately 371,000 men (21.8% of all cancers) and almost 90,000 deaths per year. Prostate cancer is the third leading cause of death from cancer (followed by lung and colorectal cancer).

Migration data show that differences in prostate cancer mortality rates are environmentally, not genetically, determined. Delaying the clinical appearance of prostate tumours by even a few years would have a significant public health impact, since prostate cancer is generally a disease of older men. Consequently, men would die with, not of, their cancer (1). One or more factors present in Asian populations appear to slow the growth and/or delay the onset of prostate tumours.
 
B. Soya foods and prostate risk

A meta-analysis of 14 studies published by Yan et al in 2009, reported that a high consumption of soya foods (more than 1 per day)  is associated with a 26% decrease in prostate cancer risk compared to low soya intake (<2/wk).

Several studies in Asian populations consistently show that soya and isoflavone intake is associated with reduced prostate cancer risk. However studies in Western men do not usually find an association. For example, results from the European Prospective Investigation into Cancer and Nutrition (EPIC) study did not find an association between isoflavone intake and prostate cancer risk in the European population. This is mainly because isoflavone intakes  are very low, on average 0.9 – 1 mg/day, and too low to find a protective effect. For this reason intakes comparable to the daily intake of a traditional Japanese diet are recommended to reduce prostate cancer incidence. The Seventh-Day Adventist study of 12,395 US men showed that frequent consumption of soya drink (at least daily) was associated with a 70% reduced risk of developing prostate cancer.

C. Use of Soya in prostate cancer patients

Scientific evidence is still preliminary but we could cautiously conclude that men in the early stage of prostate cancer (before the occurcence of metastases) can benefit from soya foods to help slow down the disease.

Intervention studies in newly diagnosed prostate cancer patients, without metastases, showed that soya drink slowed down the rise of PSA levels (prostate specific antigen - a marker for prostate cancer). PSA is a protein produced by the cells of the prostate gland and is present in small quantities in the serum of normal men, and is elevated in the presence of prostate cancer. A blood test to measure PSA is currently the most effective test available for the early detection of prostate cancer.

In a small group of American prostate cancer patients (N=29), drinking 500 ml of a soya beverage daily, for 6 months, was associated with a decline in PSA levels. Although the sample size is very small (29 patients), this study shows the potential of a soya drink to slow down the progression of prostate cancer in the early stage.

Messina et al reviewed 11 trials that examined the effects of isoflavones on serum PSA levels. The dose of isoflavones in these trials, from supplements or soya protein, ranged from 60 to 900 mg/day (typical Japanese intake is 30-50 mg/day). The results from 3 studies in healthy men with normal PSA levels, concluded that neither isoflavones nor soya protein affect serum PSA levels. Whereas in the studies involving prostate cancer patients, isoflavones significantly favorably affected PSA levels. The isoflavone intake in these studies was less than 120 mg/day- a dose that can be achieved through diet.
Chronic kidney disease is associated with a decreased capability of the kidneys to excrete waste products. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and reduced appetite. Chronic kidney disease is usually diagnosed as a result of screening of people known to be at increased risk such as those with high blood pressure or diabetes. Patients suffer from lower glomerular filtration rate resulting in higher levels of creatinine in blood. Severe chronic kidney disease requires renal replacement therapy in the form of dialysis or kidney transplantation.
In 2014 a meta-analysis consisting of nine trials comprising 197 pre-dialysis chronic kidney disease patients reviewed the effect of soy protein consumption.
http://globocan.iarc.fr/

Shimizu H, Ross RK, Bernstein L. Possible underestimation of the incidence rate of prostate cancer in Japan. Jpn J Cancer Res 1991;82:483-5.

Yan L, Spitznagel EL. Soya consumption and prostate cancer risk in men: a revisit of a meta-analysis. Am J Clin Nutr 2009.

Ward HA, Kuhnle GG, Mulligan AA, Lentjes MA, Luben RN, Khaw KT. Breast, colorectal, and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition-Norfolk in relation to phytoestrogen intake derived from an improved database. Am J Clin Nutr 2010;91:440-8.

Jacobsen BK, Knutsen SF, Fraser GE. Does high soy milk intake reduce prostate cancer incidence? The Adventist Health Study (United States). Cancer Causes Control 1998;9:553-7.

Pendleton JM, Tan WW, Anai S et al. Phase II Trial of Isoflavone in prostate specific antigen recurrent prostate cancer after previous local therapy. BMC Cancer 2008;8:132.

Kwan W, Duncan G, Van PC, Liu M, Lim J. A Phase II Trial of a Soy Beverage for Subjects Without Clinical Disease With Rising Prostate-Specific Antigen After Radical Radiation for Prostate Cancer. Nutr Cancer 2010;62:198-207.

Messina M, Kucuk O, Lampe JW. An overview of the health effects of isoflavones with an emphasis on prostate cancer risk and prostate-specific antigen levels. J AOAC Int 2006;89:1121-34.

Maskarinec G, Morimoto Y, Hebshi S, Sharma S, Franke AA, Stanczyk FZ. Serum prostate-specific antigen but not testosterone levels decrease in a randomized soy intervention among men. Eur J Clin Nutr 2006;60:1423-9.

Zhang,J.; Liu,J.; Su,J.; Tian,F.The effects of soy protein on chronic kidney disease: a meta-analysis of randomized controlled trials. Eur J Clin Nutr, 2014