Saturday, 15 March 2014

Benign prostatic hyperplasia(BPH) in Foods' Points of View

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment. Suggestion of BPH is associated to nutritional status and eating habits, according to the study, 30 male patients with clinically confirmed and treated disease of the prostatic gland, including 15 men (aged 51-75 years) with BPH and 15 men (aged 51-73 years) with PC, indicated improper nutritional status lead of incorrect nutritional habits which fail to improve their health status, may be the cause of  the development of some diet-dependent diseases, such as BPH and prostate cancer(a). A proper diet with vegetable, fruit containing zinc may reduce the risk of the disease from starting(b)(c).
  Epidemiological studies, indicated intake of vegetables and fruits accompanied with healthy life style may be associated in prevented risk and treatment of enlarged prostate(d)(e)(f), it may due to enhancement of antioxidants effect on over production of prostate cells(g)(h).

A. Types of vegetables in reduced risk of BPH
1. Tomato
Tomato is a red, edible fruit, genus Solanum, belonging to family Solanaceae, native to South America. Because of its health benefits, tomato is grown world wide for commercial purpose and often in green house. According to the study by Institute of Biological Chemistry and Nutrition, lycopene found in tomato inhibited the progression and reduced symptoms of BPH.(1) But, intake of lycopene in the study at Universität Bonn, showed no protection from the development of PCA, but in consumption of tomato products, lycopene ingestion might also be effective in PCA therapy(2). Profluss®), composition of Serenoa repens, selenium and lycopene, showed to exhibit its antiinflammatry activities in reduced risk of BPH by significant reductions of extension and grading of flogosis(3) and relieve the BHP symptoms(4). Lycopene, a major antioxidant found in tomato, according to the reviews of Monash University, in the assessment of its effect on BPH and prostate cancer found an inclusive result in supporting the reduced risk of lycopene of the diseases(5).

2. Onion
The onion is a plants in the genus Allium, belonging to the family Alliaceae, a close relation of garlic. It is often called the "king of vegetables" because of its pungent taste and found in a large number of recipes and preparations spanning almost the totality of the world's cultures. Depending on the variety, an onion can be sharp, spicy, tangy, pungent, mild or sweet. Suggestion of rich sources of flavonoids may be effective in treating benign prostatic hyperplasia (BPH)(6). According to the Istituto di Ricerche Farmacologiche Mario Negri, Intake of onion showed an inverse association of BPH(7).

3. Whole grain
Wholegrain is cereal grains containing cereal germ, endosperm, and bran. The study by Beijing Medical University, conducted in 1993-1995 in Beijing of BPH in 413 rural and 419 urban male over 40 years of age, showed an increased BPH incidence with daily intake of total calories, fat and animal protein, and the decreased daily intake of vegetables and whole grain, the sources of phytoestrogens(8). The study of the University of Illinois in Chicago, indicated an inverse associations with dietary intake of plant foods, including whole grain cereals(9). Other researchers suggested that BPH is associated with elevations in plasma estradiol/testosterone ratio, insulin, and insulin-like growth factor-I and daily aerobic exercise can reduce all of these plasma factors, particularly when combined with a low-fat, high-fiber diet consisting of whole grains, fruits, and vegetables(10).

4. Organic soybean
is genus Glycine, the family Fabaceae, one of the legumes that contains twice as much protein per acre as any other major vegetable or grain crop, native to Southeast Asia. Now, it is grown worldwide with suitable climate for commercial profit and a healthy foods. In a  rat model of benign prostatic hyperplasia (BPH), Anthocyanin, a major chemical constituent  in the pigment and potent antioxidant of black soy bean, showed to inhibit the volume and suppress the proliferation of the prostate(11) and The study Central South University, also indicated that soybean isoflavone inhibits prostate hyperplasia through increased expressions of nitric oxide and nitric oxide synthase in rats(12). The soybean Isoflavone also found to reduced the risk of prostate hyperplasia through increased acid phosphatase and PAP in a dose-dependent manner in rats, according to the Central South University, in Shanghai(13).

5. Cruciferous vegetables
Cruciferous vegetables are the group of  vegetables belonging to the family Brassicaceae, including cauliflower, cabbage, cress, bok choy, broccoli etc.
Sulforaphane (SFN) an isothiocyanate derived from cruciferous vegetables in the study of its effect in normal (PrEC), benign hyperplasia (BPH1) and cancerous (LnCap and PC3) prostate epithelial cells showed an induced cell cycle arrest and apoptosis in BPH1, through its activities in effects on cell proliferation, HDAC activity and downstream targets in normal and cancer cells(14). Ethyl isothiocyanate (PEITC), found in cruciferous vegetables, in the testing on androgen-influenced growth of the prostate such as benign hyperplasia, showed to regulate the hormone-dependent growth of the prostate, through negated the testosterone-mediated enhancement of the androgen receptor (AR), via down-regulating transcription factor Sp1 expression and Sp1 binding complex formation(15).

6. Squash
Squash is the genus Cucurbita, belongs to family Cucurbitaceae and native to Mexico and Central America. In North America, squash is divided into summer squash or winter squash, depending on the maturity of squash when harvested, immature fruit called summer squash and mature fruit called winter squash.
ProstateEZE Max, a herbal formula containing Cucurbita pepo, Epilobium parviflorum, lycopene, Pygeum africanum and Serenoa repens in the study of its effects in benign prostate hypertrophy (BPH) indicated a positive effect on physical symptoms of BPH when taken over 3 months(16). The 1Minneapolis VA Center for Chronic Diseases Outcomes Research in the reviews of 6 phytotherapeutic agents (Serenoa repens, Hypoxis rooperi, Secale cereale, Pygeum africanum, Urtica dioica, Curcubita pepo)from 44 studies, showed no convincing evidence supporting the use of Curcubita pepo alone for treatment of BPH but insisting further studies may be necessary(17).

7. Spinach
Spinach is an edible flowering plant in the genus Spinacia, belongs to the family of Amaranthaceae and native to central and southwestern Asia. It is considered as a healthy plant containing vary vitamins and minerals.
The study of the effect of 3 anti-oxidants [a water-soluble natural anti-oxidant. NAO (200 mg/kg). found in spinach leaves; epigallocatechin-3 gallate, EGCG (200 mg/kg), a major green tea polyphenol; and N-acetylcysteine, NAC (125 mg/kg)] plus vehicle in slowing spontaneous tumorigenic progression in TRAMP and wild-type male mice showed a positive effects of NAO inreduced hyperplasia at weeks 9 and 13(18). In a case-control study of prostatic cancer which consisted of 100 patients with prostatic cancer, matched for hospital, age (+/- 3 yr) and hospital admission date (+/- 3 months) to patients with benign prostatic hyperplasia (BPH) and hospital controls, conducted by the Kyoto University, indicated that frequent intake of spinach (RR = 1.96: 1.01-7.73), a typical green and yellow vegetable, was associated to risk BPH and prostate cancer(19).

8. Mushrooms
Mushroom is a standard name of white button mushroom, the fleshy, spore-bearing fruiting body of a fungus produced above ground on soil or on its food source, It is a genus A. Muscaria and belong to the family Amanitaceae and has been cultivation in many cultures all over the world for foods and health benefits. In the examination of methanol extracts of 19 edible and medicinal mushrooms on 5alpha-reductase activity indicated an inhibited effects of the testosterone-induced growth of the ventral prostate in castrated rats(20). But the study conducted by Gunma University Graduate School of Medicine, Maebashi, indicated that oral administration of extract of mushroom Phellinus linteus induced prostate enlargement(21). Therefore using mushroom in treating BPH should be taken with care only with the approval of specialist.

B. Types of fruit in reduced risk BPH
1. Orange
Orange is a species of Citrus Sinensis, belong to the family Rutaceae and native to the Southeast Asia. Orange is round citrus fruits with finely-textured skins, orange in color and one of most popular fruits in the world. The extract of red orange juice (ROE)  showed to inhibit proliferation of fibroblast and epithelial prostate cells, and may be a potential usefulness in the management of benign prostatic hyperplasia, according to University of Rome(22).

2. Water melon and strawberry
Lycopene, a member of the carotenoid family, found abundantly in Water melon, strawberry, exerted its antioxidants effect as preventive agent for prostate disease(23). The study of Profluss® on prostatic chronic inflammation (PCI) in 168 subjects, the compositions included serenoa repens+Selenium+Lycopene exhibited its anti-inflammatory activity for treatment of PCI in BPH and/or PIN/ASAP patients(24). The study by University of Messina, found that Serenoa repens, lycopene and selenium is superior than Serenoa repens alone in reducing benign prostatic hyperplasia, through reduction of  prostate weight and hyperplasia and cell proliferation and growth factor expression augmentation of apoptosis(25).

3. Cranberry
Cranberry is a species of Vaccinium oxycoccos, belong to the family Ericaceae. It is low, creeping shrubs or vines up to 2 m long and 5 to 20 cm in height and found in the cooler part of Northern America. In the study to evaluate the efficacy and tolerability of cranberry (Vaccinium macrocarpon) powder in men at risk of prostate disease with LUTS, showed a positive effects with lower total PSA level on day 180 of the study(26) and lower urinary tract symptoms of benign prostatic hyperplasia(27), In a total of 370 consecutive patients study, cranberry found to reduced urinary tract symptoms (dysuria, nocturia, urinary frequency, urgency) of that may be  in reduced risk of BPH(28).

C. Others
1. Green tea
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world.
The levels or activity of androgen hormones are associated to the risk of BPH, green tea catechin, (-)epigallocatechin-3-gallate, exhibited its modulation of androgenic activity that may be useful for the treatment of various hormone-related abnormalities, such as benign prostatic hyperplasia(29). 5 alpha-reductase activity may be involved in the development of benign prostatic hyperplasia, according to the
The Ben May Institute for Cancer Research, and The Tang Center for Herbal Medicine Research, green tea catechin (-)-epigallocatechin gallate (EGCG). EGCG showed potent inhibition in cell-free and in replacement of the gallate ester in EGCG with long-chain fatty acids produced potent 5 alpha-reductase inhibitors(30). The study by the Oregon State University, also showed that in the study of male noble rats implanted with estradiol and testosterone divided into 4 dietary groups: control, soy, tea, or soy+tea, the combinartion of  soy and tea attenuated prostate malignancy by decreasing prostate hyperplasia(31). Also, green tea catechin, (-)epigallocatechin-3-gallate, according to Dr. Liao S., may be useful for the treatment of various hormone-related abnormalities, such as benign prostatic hyperplasia, due to its modulation of androgenic activity(32).

2. Coffee
Coffee made from the roasted seeds of the genus Coffee, belonging to the family Rubiaceae native to southern Arabia.
Coffee intake has been found to be effective in reduced risk of prostate cancer, as we mentioned in the prostate cancer article. According to Dr. Morrison AS. Coffee drinking was inversely but only weakly related to prostatic hypertrophy(BPH) in 910 residents of Rhode Island who had a partial or total prostatectomy that was not related to cancer in the years 1985-1987(33). But the study of a total of 1369 patients younger than 75 years old surgically treated for BPH and 1451 controls younger than 75 years of age, showed no association of coffee intake in risk of BPH.(34)(35). and  according to the study by the Univ Estadual Paulista (UNESP) in the rat prostate gland, chronic caffeine intake from puberty may increase androgenic signalling and cell proliferation  and can be related to the development of benign prostatic hyperplasia(36).

3. Pumpkin seeds
Pumpkin seed or pepita is an edible seed of a pumpkin with flat, dark green color. Pumpkin is the genus Cucurbita and belong the family Cucurbitaceae. The origin of pumpkins is unknown, although many people believe that they have originated in North America.
Pumpkins seed has been known to consist certain chemical constituents in reduced risk and management of benign prostatic hyperplasia (BPH). Pumpkin seed, in the study of 20 male Wistar rats, conducted by the Michael Okpara University of Agriculture, inhibited the induction of BPH  and through increasing the testosterone:estradiol ratio(37). A randomized, double-blind, placebo-controlled trial in over 12 months on 47 benign prostatic hyperplasia patients with average age of 53.3 years and international prostate symptom score over 8, showed a positive effect of pumpkin seeds as complementary and alternative medicine treatments for benign prostatic hyperplasia(38). Other study also showed that oral administration of pumpkin seed oil inhibited testosterone-induced hyperplasia of the prostate(39).

4. Coconut oil
Coconut palm tree is a genus cocos, belonging to the family Arecaceae, native to the tropic and subtropic area. It is said that coconut oil may reduce total cholesterol, triglycerides, phospholipids, LDL, and VLDL cholesterol levels and increased HDL cholesterol in serum, etc.(40). Coconut oil, in the study of the effect on BPH, showed to  reduce the increase of both prostate weight (PW) and  PW:body weight (BW) ratio, markers of testosterone-induced PH in rats(41).

5. Fish oil
Fish oil, rich in long-chain polyunsaturated essential fatty acids of the omega-3 group may be used to reduced BPH risk. According to the study by the University of California at Davis, gamma-linolenic acid (GLA) from fish oil inhibited 80% of gamDHT-enhanced activity of 5 alpha-reductase with their precursor fatty acids, respectively, exerted moderate inhibition(42). Other in the study of the serum samples of 24 BPH and 19 PC patients, and from 21 age-matched normal male subjects, found that the omega-3 PUFAs level was significantly decreased in patient with BPH(43). Unluckily, the comparison of the levels of n-3 polyunsaturated fatty acids (PUFAs) in leukocytes and prostate tissue in men with prostate cancer or benign prostatic hyperplasia (BPH), indicated no association in correlation of long-chain polyunsaturated essential fatty acids  intake in reduced risk of BPH(44).

Taking altogether, with out going into reviews, certain foods have been found effectively in reduced risk and treatments of Benign prostatic hyperplasia(BPH). But large sample and multi centers studies are necessary to validate their effectiveness. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.

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(a) Nutritional status and nutritional habits of men with benign prostatic hyperplasia or prostate cancer - preliminary investigation by Goluch-Koniuszy Z, Rygielska M, Nowacka I.(PubMed)
(b) Diet and benign prostatic hyperplasia: a study in Greece by Lagiou P1, Wuu J, Trichopoulou A, Hsieh CC, Adami HO, Trichopoulos D.(PubMed)
(c) Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms by Raheem OA1, Parsons JK.(PubMed)
(d) Nutrition and benign prostatic hyperplasia by Espinosa G.(PubMed)
(e) Dietary patterns and prostatic diseases by Sebastiano C1, Vincenzo F, Tommaso C, Giuseppe S, Marco R, Ivana C, Giorgio R, Massimo M, Giuseppe M.(PubMed)
(f) Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men by Rohrmann S1, Giovannucci E, Willett WC, Platz EA.(PubMed)
(g) Evaluation of oxidative stress and DNA damage in benign prostatic hyperplasia patients and comparison with controls by Ahmad M1, Suhail N, Mansoor T, Banu N, Ahmad S(PubMed).
(h) Oxidative stress and antioxidant status in non-metastatic prostate cancer and benign prostatic hyperplasia by Aydin A1, Arsova-Sarafinovska Z, Sayal A, Eken A, Erdem O, Erten K, Ozgök Y, Dimovski A.(PubMed)
(1) Lycopene inhibits disease progression in patients with benign prostate hyperplasia by Schwarz S1, Obermüller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski HK(PubMed).
(2) [Tomatoes and lycopene in prevention and therapy--is there an evidence for prostate diseases?].

[Article in German] by Ellinger S1, Ellinger J, Müller SC, Stehle P.(PubMed)
(3) Effects of Serenoa repens, selenium and lycopene (Profluss®) on chronic inflammation associated with benign prostatic hyperplasia: results of "FLOG" (Flogosis and Profluss in Prostatic and Genital Disease), a multicentre Italian study by Morgia G1, Cimino S, Favilla V, Russo GI, Squadrito F, Mucciardi G, Masieri L, Minutoli L, Grosso G, Castelli T.(PubMed)
(4) Treatment of chronic prostatitis/chronic pelvic pain syndrome category IIIA with Serenoa repens plus selenium and lycopene (Profluss) versus S. repens alone: an Italian randomized multicenter-controlled study by Morgia G1, Mucciardi G, Galì A, Madonia M, Marchese F, Di Benedetto A, Romano G, Bonvissuto G, Castelli T, Macchione L, Magno C.(PubMed)
(5) Lycopene for the prevention and treatment of benign prostatic hyperplasia and prostate cancer: a systematic review by Ilic D1, Misso M(PubMed).

(8) Changes in the prevalence of benign prostatic hyperplasia in China by Gu F.(PubMed)
(9) Correlations of dietary patterns with prostate health by Stacewicz-Sapuntzakis M1, Borthakur G, Burns JL, Bowen PE.(PubMed)
(10) Benign prostatic hyperplasia: does lifestyle play a role by Barnard RJ1, Aronson WJ.(PubMed)
(11) Anthocyanin extracted from black soybean reduces prostate weight and promotes apoptosis in the prostatic hyperplasia-induced rat model by Jang H1, Ha US, Kim SJ, Yoon BI, Han DS, Yuk SM, Kim SW.(PubMed)
(12) [Effects of soy bean isoflavone on inhibition of benign prostatic hyperplasia and the expressions of NO and NOS of rats].[Article in Chinese] by Yang A1, Ren G, Tang L, Jiang W.(PubMed)
(13) [Inhibitive effect of soybean isoflavone on prostate hyperplasia in rats].[Article in Chinese] by Ren GF1, Huang YM.(PubMed)
(14) Differential effects of sulforaphane on histone deacetylases, cell cycle arrest and apoptosis in normal prostate cells versus hyperplastic and cancerous prostate cells by Clarke JD1, Hsu A, Yu Z, Dashwood RH, Ho E.(PubMed)
(15) Modulating testosterone stimulated prostate growth by phenethyl isothiocyanate via Sp1 and androgen receptor down-regulation by Beklemisheva AA1, Feng J, Yeh YA, Wang LG, Chiao JW.(PubMed)
(16) A phase II randomised double-blind placebo-controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: a herbal medicine preparation for the management of symptoms of benign prostatic hypertrophy by Coulson S1, Rao A, Beck SL, Steels E, Gramotnev H, Vitetta L.(PubMed)
(17) Phytotherapy for benign prostatic hyperplasia by Wilt TJ1, Ishani A, Rutks I, MacDonald R.(PubMed)
(18) Slowing tumorigenic progression in TRAMP mice and prostatic carcinoma cell lines using natural anti-oxidant from spinach, NAO--a comparative study of three anti-oxidants by Nyska A1, Suttie A, Bakshi S, Lomnitski L, Grossman S, Bergman M, Ben-Shaul V, Crocket P, Haseman JK, Moser G, Goldsworthy TL, Maronpot RR.(PubMed)
(19) A case-control study of prostatic cancer with reference to dietary habits by Oishi K1, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH.(PubMed)
(20) Anti-androgenic activities of Ganoderma lucidum by Fujita R1, Liu J, Shimizu K, Konishi F, Noda K, Kumamoto S, Ueda C, Tajiri H, Kaneko S, Suimi Y, Kondo R.(PubMed)
(21) Administration of extract of mushroom Phellinus linteus induces prostate enlargement with increase in stromal component in experimentally developed rat model of benign prostatic hyperplasia by Shibata Y1, Kashiwagi B, Arai S, Fukabori Y, Suzuki K.(PubMed)
(22) Effect of a standardized extract of red orange juice on proliferation of human prostate cells in vitro by Vitali F1, Pennisi C, Tomaino A, Bonina F, De Pasquale A, Saija A, Tita B.(PubMed)
(23) Lycopene for the prevention and treatment of prostate disease by Ilic D.(PubMed)
(24) Effects of Serenoa repens, selenium and lycopene (Profluss®) on chronic inflammation associated with benign prostatic hyperplasia: results of "FLOG" (Flogosis and Profluss in Prostatic and Genital Disease), a multicentre Italian study by Morgia G1, Cimino S, Favilla V, Russo GI, Squadrito F, Mucciardi G, Masieri L, Minutoli L, Grosso G, Castelli T.(PubMed)
(25) [The association of Serenoa repens, lycopene and selenium is superior to Serenoa repens alone in reducing benign prostatic hyperplasia].[Article in Italian] by Squadrito F1, Morgia G.(PubMed)
(26) The effectiveness of dried cranberries ( Vaccinium macrocarpon) in men with lower urinary tract symptoms by Vidlar A1, Vostalova J, Ulrichova J, Student V, Stejskal D, Reichenbach R, Vrbkova J, Ruzicka F, Simanek V.(PubMed)
(27) Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community based population of healthy aging men: the Krimpen Study by Kok ET1, Schouten BW, Bohnen AM, Groeneveld FP, Thomas S, Bosch JL.(PubMed)
(28) Enteric-coated, highly standardized cranberry extract reduces risk of UTIs and urinary symptoms during radiotherapy for prostate carcinoma by Bonetta A1, Di Pierro F.(PubMed)
(29) The medicinal action of androgens and green tea epigallocatechin gallate by Liao S.(PubMed)
(30) Structure-activity relationships for inhibition of human 5alpha-reductases by polyphenols by Hiipakka RA1, Zhang HZ, Dai W, Dai Q, Liao S.(PubMed)
(31) Dietary soy and tea mitigate chronic inflammation and prostate cancer via NFκB pathway in the Noble rat model by Hsu A1, Bruno RS, Löhr CV, Taylor AW, Dashwood RH, Bray TM, Ho E.(PubMed)
(32) The medicinal action of androgens and green tea epigallocatechin gallate by Liao S.(PubMed)
(33) Risk factors for surgery for prostatic hypertrophy by Morrison AS.(PubMed)
(34) Food groups and risk of benign prostatic hyperplasia. by Bravi F1, Bosetti C, Dal Maso L, Talamini R, Montella M, Negri E, Ramazzotti V, Franceschi S, La Vecchia C.(PubMed)
(35) Benign prostatic hyperplasia: the opposite effects of alcohol and coffee intake by Gass R.(PubMed)
(36) Chronic caffeine intake increases androgenic stimuli, epithelial cell proliferation and hyperplasia in rat ventral prostate by Sarobo C1, Lacorte LM, Martins M, Rinaldi JC, Moroz A, Scarano WR, Delella FK, Felisbino SL.(PubMed)
(37) Inhibition of the experimental induction of benign prostatic hyperplasia: a possible role for fluted pumpkin (Telfairia occidentalis Hook f.) seeds by Ejike CE1, Ezeanyika LU.(PubMed)
(38) Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia by Hong H1, Kim CS, Maeng S.(PubMed)
(39) Inhibition of testosterone-induced hyperplasia of the prostate of sprague-dawley rats by pumpkin seed oil by Gossell-Williams M1, Davis A, O'Connor N.(PubMed)
(40) Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation. Nevin KG. Rajamohan T. Clinical Biochemistry. 37(9):830-5, 2004 Sep. [Comparative Study. Journal Article] UI: 15329324 Authors Full Name Nevin, K G. Rajamohan, T.
(41) Effects of coconut oil on testosterone-induced prostatic hyperplasia in Sprague-Dawley rats. by de Lourdes Arruzazabala M1, Molina V, Más R, Carbajal D, Marrero D, González V, Rodríguez E.(PubMed)
(42) 5 alpha-reductase-catalyzed conversion of testosterone to dihydrotestosterone is increased in prostatic adenocarcinoma cells: suppression by 15-lipoxygenase metabolites of gamma-linolenic and eicosapentaenoic acids by Pham H1, Ziboh VA.(PubMed)
(43) Comparison of fatty acid profiles in the serum of patients with prostate cancer and benign prostatic hyperplasia by Yang YJ1, Lee SH, Hong SJ, Chung BC.(PubMed)
(44) Prostate tissue and leukocyte levels of n-3 polyunsaturated fatty acids in men with benign prostate hyperplasia or prostate cancer by Christensen JH1, Fabrin K, Borup K, Barber N, Poulsen J.(PubMed)

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