Tomatoes and prostates? A tomato a day will keep the urologist away.

The apple ain’t got nothing on the tomato!

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Article Reviewed: Lycopene Inhibits Disease Progression in Patients With Benign Prostate Hyperplasia. Schwarz S, Obermuller-Jevic UC, et al: J Nutr; 2008; 138 (January): 49-53.

Lycopene Inhibits Disease Progression in Patients With Benign Prostate Hyperplasia.

Schwarz S, Obermuller-Jevic UC, et al:
J Nutr; 2008; 138 (January): 49-53

Background: Lycopene is a carotenoid found in a variety of healthy foods such as tomatoes, watermelon, and pink grapefruit. It has garnered interest in the area of prostate cancer prevention, but has yet to receive adequate attention in the area of benign prostate hyperplasia (BPH). Objective: To determine the serologic, tissue, and clinical impact of higher plasma lycopene levels in patients with histologically proven BPH. Design/Methods: This was a randomized trial of 40 patients who received 15 mg per day of lycopene from a dietary supplement or a placebo for 6 consecutive months. Patients completed 4 visits at the medical practice during the 6-month period at baseline, after 1 month, after 3 months, and after 6 months. The primary end point was the reduction of increased PSA levels. Results: The mean patient age was 67 years and body mass index was 26 (slightly overweight). PSA levels decreased significantly in the lycopene group after 6 months from 6.6 mcg/L to 5.8 mcg/L, and there was no PSA change in the placebo group. Progression of prostate enlargement did not occur in the lycopene group compared to placebo as assessed by transrectal ultrasonography (TRUS) and digital rectal examination (DRE). Disease symptoms according to the International Prostate Symptom Score questionnaire significantly improved in both groups, but to a greater degree with lycopene. However, the placebo group experienced significantly greater reductions in LDL cholesterol compared to the lycopene group.

Conclusions: Lycopene at a dose of 15 mg/day may inhibit the progression of BPH.

Reviewer’s Comments: Lycopene from diet and supplements has not experienced impressive data as of late in the area of prostate cancer research. Perhaps the earlier use of lycopene in healthy patients with BPH was a more ideal opportunity to test the impact of this supplement. The most impressive finding was not the reduction of PSA by lycopene, but that both groups reduced their intake of overall calories to a large degree during the trial. In the Prostate Cancer Prevention Trial (PCPT), men in the placebo arm that reduced their caloric intake also reduced their PSA velocity. In other words, is the lycopene supplement responsible for the favorable impact in this study, or the fact that men reduced caloric intake, which may have also caused the LDL and PSA reductions? (Reviewer–Mark A. Moyad, MD, MPH).

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