By Martin S. Lipsky, MD

Adjunct Professor, Institute on Aging, School of Community Health, Portland State University;
Dean Emeritus, University of Illinois College of Medicine, Rockford

Dr. Lipsky is a retained consultant for Health Solutions & Strategies.

SYNOPSIS: Reducing sedentary time could have a protective effect and reduce the prevalence of BPH.

SOURCE: Lee HW, et al. The study about physical activity for subjects with prevention of benign prostatic hypertrophy. Int Neurourol J 2014;18:155-162.

Although not a life-threatening condition, benign prostatic hypertrophy (BPH) is one of the most annoying and troublesome problems that plagues aging males. Traditional risk factors, such as age, family history, and hormones, are considered the main risk factors for BPH, but lifestyle elements, such as physical activity (PA), smoking, and drinking, likely also play a role in developing BPH.1,2 In this study, Lee and colleagues investigated the effects of PA on the risk of BPH in men older than age 40.

This Korean study used a cross-sectional survey performed annually for 3 years by trained interviewers to identify men with BPH and to collect information about their smoking, drinking, diet, and PA habits. Of an initial 779 men, 582 with urinary symptoms underwent a digital rectal exam, PSA screening, and rectal ultrasonography (US) to assess prostate size and to identify prostate cancer. BPH was defined as a prostate volume of 25 mL or more (by US) and a score of eight or more using the International Prostate Symptom Score. PA was broken into several variables, and levels of PA were assessed using questionnaires validated in previous studies.3,4 The association of PA and BPH was analyzed by logic regression analysis using multivariable regression models.

Among the variables for PA selected, regular exercise, frequency of exercise, nonsedentary time, and leisure time PA did not show a statistically significant association with BPH. Sedentary time (hrs/day) was divided into three groups (low, medium, and high). Analysis showed that BPH was higher among those with the highest sedentary time (> 7 hours/day) and demonstrated a trend toward significance for a P value of 0.05 (OR, 1.72; 95% confidence interval, 0.96-3.09).

The authors concluded that reducing sedentary time could have a protective effect and reduce the prevalence of BPH.

COMMENTARY

More and more research is demonstrating that prolonged sitting raises the risk of dying from cardiac and metabolic diseases, even if you work out.5,6 While one might not necessarily connect BPH with being sedentary, this study adds to the growing body of literature about the dangers of sitting. Even though this study is small and the results only trended toward significance, the benefits of avoiding prolonged sitting are accumulating, and it would seem beneficial to advise men with sedentary occupations to become more active at work. Suggestions might include standing more at work by using a standing desk, standing whenever talking on the telephone, trying to get up to walk a bit for a few minutes every hour, and if one must sit, consider using a "stability ball” to engage the core muscles while sitting.

REFERENCES

  1. 1.Parsons JK, et al. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol 2008;53:1228-1235.
  2. 2.Rohrmann S, et al. Association of cigarette smoking, alcohol consumption, and physical activity with lower urinary tract symptoms in older American men: Findings from the third National Health and Nutrition Examination Survey. BJU Int 2005;96:77-82.
  3. 3.Sallis JF, et al. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol 1985;121:91-106.
  4. 4.Platz EA, et al. Physical activity and benign prostatic hyperplasia. Arch Intern Med 1998;158:2349-2356.
  5. 5.Owen N, et. al. Sedentary behavior: Emerging evidence for a new health risk. Mayo Clin Proc 2010;85:1138-1141.
  6. 6.Katzmarzyk PT, et. al. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009;41:998-1005.