Prostate health and healthier lifestyle choices

This section is aimed at helping you understand, more about what is meant by healthier lifestyle choices that you may like to consider for your prostate health and in fact your general health and well-being. Lifestyle choices are more than just about the food you eat – it’s also about exercise, weight, alcohol and smoking.

Regularly, there are stories in newspapers and in the media often giving conflicting information about foods that are ‘good for you’ and foods that are ‘bad for you’ and all this information can be very confusing. Generally doctors agree that men with an average risk of prostate disease and prostate cancer make choices that benefit their overall health by choosing healthier foods, taking regular exercise, stopping smoking and keeping alcohol within recommended guidelines.

At the moment there is no sure way or quick fix miracle nutrient, supplement or diet to prevent prostate disease or prostate cancer and it may be a case of considering changing your whole way of eating and choosing healthier foods. Involving the whole family in making healthier food choices may make it easier and may also benefit their general health and well-being.

That said, there are some foods that you might like to think about making part of your everyday diet as these may reduce the risk of developing certain types of cancer including prostate cancer. Although not conclusive, many studies have shown that natural chemicals in plant foods, called antioxidants, may help reduce the risk of developing certain kinds of cancer including prostate cancer. You can read more about these foods later.

General guidelines for healthier eating:

  • Aim to have a wide variety of different foods and try foods that you may not have had before especially different fruits and vegetables
  • Start the day by having breakfast, skipping breakfast can lead to a lack of concentration and snacking on possibly higher calorie foods later in the morning
  • Include protein foods each day especially those which are lower in fat; lean meats, fish, chicken, turkey, venison, pheasant, rabbit, oily fish and pulses such as peas, beans and lentils

Choose high fibre carbohydrate foods such as wholegrain cereals, oats, wholemeal bread, brown rice, wholewheat pasta

  • Have at least 5 portions of fruit and vegetables every day in a ‘rainbow of colours’. Choose dishes that are made from a wide variety of vegetables
  • Swap full-fat dairy foods to low fat varieties and use semi-skimmed or skimmed milk
  • Cut down on the amount of fat and fatty foods that you have and choose polyunsaturated varieties and spreads. Banish the chip pan and the frying pan and only have fried foods occasionally
  • Try having hot drinks without adding sugar and cut down on sugary drinks, sweets, chocolate, cakes and biscuits
  • Keep an eye on your weight. By cutting down on fatty foods, fries and sweet, sugary foods this should go some way to helping you lose weight or keeping to a healthy weight
  • Make sure you take enough fluid every day by having about 6 – 8 glasses each day whether this is as tea, coffee, sugar-free soft drinks, water, herbal or fruit teas

What are healthier food choices?
What does the eatwell plate mean?

Carbohydrate or starchy foods.

Plan your meals and snacks to include one of these foods at each meal.

Starchy foods include:

Bread Whenever possible switch from eating white bread to wholemeal, wholegrain or seed varieties

To ring the changes have chappatis, pitta, tortilla, naan bread although some of these may have more fat added or spread over

Breakfast cereals Choose bran varieties rather than ‘white’ and avoid those with added sugar, coated and with sugar or chocolate. Porage oats, oatmeal for porridge and muesli are very good choices for slow release carbohydrate
Rice and noodles Try brown rice for a change
Pasta Try wholewheat pasta
Potatoes Boiled, baked, mashed or potato wedges. Keep chips to an occasional treat

Fruit and vegetables

Enjoy a wide variety of different types and colours of fruit and vegetables and have at least five portions each day. These can be; fresh, frozen, tinned, or dried. One portion can be taken as fresh fruit juice each day if you prefer. Another easy way to include vegetables is by adding to soups, stews, casseroles or sauces.

Let’s take a look at the role of specific fruits and vegetables which have been reported to be associated with a lower risk of prostate cancer and why that might be.

Plant foods produce phytochemicals and research seems to indicate that they might have a protective effect for us against diseases. Many phytochemicals have antioxidant actions and although not all results are conclusive, many studies have shown that antioxidants may reduce the risk of developing certain types of cancer including prostate cancer.

An easy way to help make sure that you are getting a variety of antioxidants from your food is by thinking of these as colour groups and include foods of each colour every day. Different coloured fruit and vegetables have their own special combination of minerals and vitamins too.

Fruits and vegetables

Group Fruits Special notes
Red Tomatoes, watermelon, pink grapefruit contain lycopene. Tomatoes are a good source of lycopene and studies have suggested that cooked tomatoes are even better than the raw fruit. So aim to have meals with a tomato-based sauce at least twice a week.

Try to include foods containing lycopene every day – tomato sauce, tomato soup, tinned tomatoes, tomato juice, sundried tomatoes, tomato ketchup, tomato puree or tomatoes in your diet every week.

It would seem from research that having lycopene from tomato products in your diet is much better than taking lycopene supplements.

Red/purple Pomegranates, grapes, plums and red/purple berries Pomegranates contain polyphenols and studies are continuing to find out if these may help to reduce the risk of prostate cancer but as yet nothing has been conclusive. So although it’s not proven, it may be beneficial to include pomegranate or pomegranate juice.
Orange Carrots, mangoes, apricots, pumpkin cantaloupes, sweet potatoes, Include as part of your healthy diet every week.
Orange/yellow Oranges, peaches, papaya, nectarines, tangerines Include as part of your healthy diet every week.
Yellow/green Spinach,

corn on the cob, green peas, avocado,

honeydew melon

Include as part of your healthy diet every week.
Green Broccoli, bok choi, cabbage, cauliflower, kale, radishes, sprouts, swede, turnip, watercress You may also hear these called cruciferous vegetables. It has been suggested that you should try to have at least 5 portions of these vegetables every week.
White/green Garlic, onions,

asparagus, leeks, shallots, and chives

Include as part of your healthy diet every week. Fresh crushed garlic is the best way to include garlic in your diet rather taking garlic supplements.

A word about lycopene…
Lycopene is a naturally occurring substance in fruits and vegetables which gives them their red/reddish colour. It is a powerful antioxidant that may help protect cells from damage.

Meat, fish, eggs and pulses

These should be eaten in moderate amounts. Choose lean cuts of meat and trim off any excess fat. It’s best to avoid processed meats (such as bacon, burgers, sausages, pies) or include these only occasionally.

Chicken and turkey are lower in fat but avoid frying or eating the skin.

Venison, pheasant, rabbit are fairly low in fat too.

Try to include two portions of fish each week for example haddock, plaice, tinned tuna, cod. If possible have oily fish once week eg: mackerel, trout, salmon – fresh or frozen, sardines, kippers, pilchards, sardines or fresh tuna.

Beans and lentils

These are also protein foods and much lower in fat so can replace meat, eggs, fish or chicken if preferred. These are also good sources of fibre.

Dairy Foods

Studies seem to suggest that a pint of milk a day or the equivalents may be important to ensure that there is an adequate amount of calcium in the diet, but not eating excess amounts of dairy foods. For example the following contain the same amount of calcium as 1/3 pint of milk:

  • a small pot of yoghurt
  • a small matchbox size piece of cheese

Rather than having full-fat varieties, try to choose reduced fat versions where you can – for example semi-skimmed milk, low fat yoghurt, cottage cheese and half fat Cheddar cheese or Edam.

You may also like to think about switching to include some soya dairy alternatives such as soya milk, spreads and cheese and perhaps trying Tofu which is soya bean curd.

Fats

Fats can be divided into 2 groups; saturated and unsaturated.

Unsaturated fats Such as sunflower, soya, corn, olive and rapeseed oil

Using soft spreads and margarines but check the ingredients carefully before buying

Saturated fats Such as butter, hard margarines, fat on meats, lard, suet, ghee, cream, cakes, biscuits

It is best to choose the unsaturated variety of fats but bear in mind that these have the same calorie value as saturated fats so don’t use too much of these if you are trying to lose weight or keep a healthy body weight.

Sugar and sweet foods

If you are trying to keep a healthy body weight or are perhaps trying to lose some weight, then cut out or cut down on the sugar you add to hot drinks or switch to using a sweetener. If you drink a lot of fizzy, sugary drinks switch to the low calorie versions instead. Only have sweets, chocolate, cakes and biscuits as occasional treats.

To help sum up what this might mean:
There are no shortcuts to having a healthy diet and it can be a lot easier than you think to incorporate healthy foods into your everyday diet. It doesn’t necessarily mean giving up all the foods that you enjoy but having these as foods as occasional treats.

It might be best to make ‘better’ food choices gradually, making simple, small changes to your existing diet on a regular basis. Then after just a few months, you’ll be well on your way to having a much healthier diet.

Particular nutrients of interest

Selenium

Selenium is a mineral which is required to keep us healthy but is only needed in very small amounts. Some studies have shown that there may be an increased risk of prostate cancer in men who have low selenium levels. Selenium might affect prostate cancer risk in two ways. As an anti-oxidant, selenium can help protect the body from damaging effects of free radicals. Selenium may also prevent or slow tumor growth, as certain breakdown products of selenium are thought to prevent tumours growing larger.

The best dietary sources of selenium are:

  • Brazil nuts
  • Tuna fish, fish and other sea-foods
  • Liver and kidney
  • Meat and poultry
  • Eggs
  • Whole grains, and cereals
  • Sunflower seed kernels, dry roasted

It has been suggested that having a brazil nut every day would provide enough selenium in your diet. You will probably have seen that you can buy selenium supplements. However a word of caution; these may be poisonous to our bodies if the selenium level is raised above what the body can cope with. Too much selenium taken over a period of weeks or months can cause gradual toxic effects.

Polyphenols

Polyphenols are anti-oxidants found in plant foods. Good sources of polyphenols include blueberries, strawberries, raspberries, citrus fruits, dark grapes, cherries, apples, dark plums and blackberries. Dark grape juice is also a good source.

From time to time articles appear in the media about the benefits of drinking green tea which is also a good source of polyphenols. Studies of men who drank green tea or took green tea extract as a supplement have been reported to have had a reduced risk of prostate cancer. If you like to drink tea, consider sometimes substituting green tea instead of your usual brew.

It has been suggested by some researchers that regularly drinking 6 cups of coffee or more each day (whether ordinary or de-caffeinated) may reduce the risk of developing the aggressive form of prostate cancer. In fact they put forward that drinking even 1 – 3 cups of coffee each day was associated with a lower risk of developing prostate cancer. Coffee was chosen for the study as it contains many substances that act as antioxidants. However, researchers are continuing to look into why coffee seems to have this beneficial effect.

Because red wine is produced from dark coloured grapes, it also contains polyphenols. However it is best not to go over the recommended guidelines for any type of alcohol.

Vitamin E

Vitamin E is a fat-soluble that is an anti-oxidant. Previously it was thought that taking a vitamin E supplement may have helped reduce the risk of prostate cancer. However, a recent study has suggested the contrary; that men who regularly took Vitamin E supplements concluded that they may in fact have a slightly higher risk of developing prostate cancer compared to men who didn’t.

Dietary Supplements

Having a healthy diet as outlined above is by far the best; dietary supplements are a supplement to a healthy diet and shouldn’t be used as a replacement for a healthy diet. So, the best advice is to eat a well-balanced diet and avoid focusing on any one food that is thought to be a “cancer-fighting” food. Taking mega-doses of any individual vitamin or mineral may in fact not be recommended.

Having a healthy diet is a great way of making sure that you are getting the right types and amounts of vitamins and minerals and in a way that can be used most easily by the body.

If you have decided to or are already taking any type of dietary supplement then you should always let your doctor or CNS know. Make sure that you have checked to find out what is actually in the supplement(s) before you them and buy any supplements from a reputable supplier.

Your weight

Being overweight can bring with it many health problems so, if appropriate, you may want to think about losing weight. Recent studies have suggested that there is an increased risk of developing advanced prostate cancer if the man is very overweight or obese. It has also been recognised that men who are very overweight are more at risk of developing BPH.

Obesity has also been linked to lower survival and lower quality of life issues in cancer survivors.

The best way to do this is to cut down the amount of calories you eat and at the same time take more exercise each day (see exercise section).

To reduce the amount of calories you eat follow a healthy diet and also cut down or cut out sugar, sugary drinks, sweets, chocolate, cakes, puddings, fried foods, crisps and take-aways. If you are very overweight your doctor may refer you to a weight loss clinic.

Alcohol intake

As long as you’ve not been told to avoid alcohol, it’s best to keep alcohol intake to a moderate amount and within sensible drinking limits, trying to have a couple of ‘alcohol free’ days each week. In addition, if you find that your bladder is irritated then perhaps try cutting out alcohol.

For more information on sensible drinking limits go to www.drinkaware.co.uk Helpful sections include ‘Understanding unit guidelines’, ‘Should you take a break from alcohol’ and ‘How much alcohol is too much’

Exercise

Recent studies have all pointed to the benefit of taking regular exercise. Aim for 30 minutes of moderate exercise every day, 5 times a week. Moderate exercise can include going for a brisk walk, swimming, mowing the lawn, doing the gardening or washing and polishing the car. This may help with your general health and feeling of wellbeing and may help if you need to lose some weight. There are lots of people to help you get started; your doctor may refer you to a physiotherapist, there may be specialist exerciseprogrammes at your local leisure centre or join a local walking group.

Exercise has also been shown to be an effective self-help intervention for fatigue during cancer treatment, and has been recommended for older cancer survivors. Resistance training, to help muscle strength, may be of particular benefit for men with prostate cancer who are on hormone therapy.

If you haven’t exercised for a long time then you will need to build this up gradually. Always check with your doctor before starting to exercise.

Smoking

Smoking can affect your health in many ways so the best advice is to give up. Giving up can be difficult and it may be worth discussing this with your CNS, GP, pharmacist or local stop smoking advisor.

Cooking methods

The way food is cooked is also very important. It’s been found that when beef, pork, chicken, fish, sausages and burgers are grilled at high temperatures cancer causing substances can be found in the foods.

Similarly, when these foods are cooked on a barbecue another type of cancer causing substance is formed on the surface of the meat by smoke and flames when the fat and juices from the meats drip down onto the barbecue coals or gas flame below.

To help avoid this stew, braise or poach foods.

If you are barbecuing then consider:

  • Reducing the amount of time the food is left on the barbecue to cook. Perhaps start off cooking the food in the microwave or cooker top then finish on the barbecue
  • Choose lean meats without too much fat or trim off the excess fat so the juices don’t drip down onto the barbecue causing a sudden flame
  • Cook the meats thoroughly but don’t allow them to become blackened or trim off as the cancer causing substances are in the blackened areas