Impact of Lifestyle and the Microbiome on Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

Recent studies have facilitated a new understanding of how the microbiome and lifestyle contribute to the pathophysiology of prostatic diseases. This mini review explores evidence on the role of lifestyle, diet, and the microbiome in the development and progression of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Diet, physical activity, and the gut microbiome may influence LUTS/BPH by modulating systemic inflammation and metabolic processes. Proinflammatory diets, particularly those high in animal-based foods and low in fiber, affect systemic inflammation, leading to LUTS. Changes in the gut microbiota can alter the production of short-chain fatty acids and contribute to insulin resistance and other metabolic disturbances that may exacerbate prostate inflammation and accelerate LUTS progression. BPH development is influenced by a complex interplay of lifestyle factors, the metabolic syndrome, and the composition of the microbiota. More research into the pathophysiology of BPH is warranted to increase the evidence supporting lifestyle-based strategies in BPH prevention and management. PATIENT SUMMARY: There seems to be a link between lower urinary tract symptoms (LUTS) caused by an enlarged prostate and lifestyle, diet, and gut microbes. LUTS can be increased by factors such as a diet rich in red meat and animal protein and poor in fiber, and physical inactivity. Obesity may change the composition of microbes in the gut, which in turn increases inflammation, including in the prostate. Addressing these factors could help in preventing LUTS.