Over 30 million individuals in the United States are living with a urologic condition that not only causes them discomfort, but can also be quite costly (1). While healthy lifestyle choices in general help maintain one’s urologic health (1), it’s also important to note the dietary and supplementation choices available to help keep problems at bay.

Urinary Tract Infections (UTIs)
UTIs cause more than 8.1 million visits to healthcare providers each year (2). Although both males and females can develop a UTI, infections occur more frequently in women. It is estimated that more than 50% of women will experience at least one UTI in her lifetime and 20–30% of women who experience a UTI will have two or more recurrent episodes (3). When treated promptly and properly, minor UTIs rarely lead to complications. If they are left untreated, recurrent infections, kidney damage, Sepsis and pregnancy complications can occur. Once a UTI has been identified by a doctor, traditional treatment calls for antibiotics. But due to side effects and the risk of antibiotic resistance, many are interested in natural alternatives for urinary support before problems start (4, 5).

One natural option that has been widely used is cranberries (3). Originally, it was believed that the acidic nature of cranberries created an acidic environment in the urine that was not favorable to pathogenic growth. However, that theory has since been discredited. Most recently, researchers have found A-type proanthocyanidins (PACs) to be the active ingredients in cranberries that prevent the adhesion of bacteria, particularly E. coli, to the bladder wall (6). In a 2012 Cochrane Review study, researchers concluded that while cranberries did not reduce UTI symptoms in everyone, they did decrease UTI symptoms in women with recurrent UTIs over a 12-month period. In a 2015 randomized placebo-controlled trial, it was concluded that whole cranberry powder reduced the recurrence of UTIs. In regards to whether cranberries are most effective in a juice or supplement form, many believe supplements are a better option for avoiding extra sugar and increasing potency (6).
 
Probiotics
Like cranberry, the use of probiotic supplements, especially lactobacilli, may be another tool in the fight against UTIs. New studies reveal that since Lactobacillus is already present in healthy vaginal flora, regularly supplementing with it may help contribute to a healthy balance of good to bad bacteria (7). In a 2011 study of 100 women published in Clinical Infectious Diseases, the use of Lactobacillus crispatus by intravaginal suppository showed a reduced rate of recurrent UTIs in women prone to the infection. The downside of the study is that the probiotic used in the study is not available yet and may require more testing before it may be used for this purpose (3). Other strains like Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 are said to offer similar urinary health benefits.
 
Prostate Care
A common urologic problem in men younger than 50 is prostatitis (8), inflammation of the prostate causing pain and difficulty during urination. Benign prostatic hyperplasia (BPH) can lead to similar issues and is common in men over 50. While researchers do not fully understand why BPH occurs, chronic inflammation may play an important role in the cause (9).

While the U.S. Food and Drug Administration (FDA) has not approved natural alternatives as treatments for prostatitis or BPH, there are ways to support prostate health throughout life. One popular herb used for this purpose is saw palmetto. According to the American Cancer Society, saw palmetto berries inhibit the body’s production of the enzyme 5-alpha reductase.

By preventing the enzyme from converting testosterone into dihydrotestosterone (DHT), the theory is that saw palmetto lowers hormones and therefore reduces prostate cell growth and BPH/prostatitis symptoms. In a 2010 study of 100 men, saw palmetto helped with the pain and discomfort associated with prostatitis. In another small study, saw palmetto was effective for alleviating BPH symptoms, though more research is needed. In a 2012 study published in the Journal of the American Medical Association, researchers found saw palmetto had no greater symptom relief than a placebo (9).

Research continues on this front, with a 2016 in vitro study testing whether a branded CO2 supercritical saw palmetto extract (Prosterol) would sufficiently inhibit 5-alpha reductase isoenzyme type II, which is found primarily in the prostate tissue. Results showed the extract not only effectively inhibited the enzyme, but also that it compared favorably with a standard drug therapy, Finasteride (10).  

Pygeum has also been studied for prostate health. According to the Memorial Sloan Kettering Cancer Center, pygeum stops the production of prostaglandins, indicators of inflammation in the body. These compounds also work synergistically to reduce levels of testosterone in the prostate. In clinical trials conducted in 2011, pygeum extract helped reduce urinary symptoms caused by BPH (11).

Clinical studies have also found rye grass pollen to reduce the frequency of night time urination and the amount of urine left in the bladder (12).

Some people also believe pumpkin seeds and pumpkinseed extract may benefit men’s health because the phytosterols support balanced inflammation in the body and may stop testosterone from turning into DHT. Men should speak with a doctor to decide whether any of these options can be safely incorporated into their daily regimens. WF

References

1. University Of California, San Francisco. 2015.  “Urologic Diseases,” https://support.ucsf.edu/giving-areas/urologic-diseases.
2. Urology Care Foundation, The Official Foundation of the American Urological Association. 2015. “What is a Urinary Tract Infection (UTI)?” http://www.urologyhealth.org/urologic-conditions/urinary-tract-infections-in-adults.
3. Winston, D. Upton, R. Graff, A. Brinckmann, J. et al. 2016. Cranberry Fruit. Pg. 38. Scotts Valley, CA: American Herbal Pharmacoppoeia
4. Caljouw, M. Hout, W. Putter, H. Cools, H. Gussekloo, J. 2014. Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infections in Vulnerable Older Persons: A Double-Blind Randomized Placebo-Controlled Trial in Long-Term Care Facilities. Journal of the American Geriatrics Society. [Online] 62, (1). Available: http://onlinelibrary.wiley.com/doi/10.1111/jgs.12593/pdf
5. Tiruneh, M. Yifru, S. Gizachew, M. Molla, et al., 2014. Changing Trends in Prevalence and Antibiotics Resistance of Uropathogens in patients Attending the Gondar University Hospital, northwest Ethiopia. International Journal of Bacteriology. [Online] 2014, Article ID 629424. Available: http://www.hindawi.com/journals/ijb/2014/629424/cta/
6. Worcester Polytechnic Institute. "Compounds In Cranberries May Be Antibacterial Agents." ScienceDaily. ScienceDaily, Accessed: 14 November 2007.  Available: http://www.sciencedaily.com/releases/2007/11/071113132240.htm.
7. Cribby, S., Taylor, M., & Reid, G. (2008). Vaginal Microbiota and the Use of Probiotics. Interdisciplinary Perspectives on Infectious Diseases, 2008, 256490. http://doi.org/10.1155/2008/256490
8. Urology at University of California, Los Angeles. 2015. Male Urology. http://urology.ucla.edu/body.cfm?id=54
9. National Institute of Diabetes and Digestive and Kidney Diseases. 2014. Prostate Enlargement: Benign Prostatic Hyperplasia. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperplasia-bph/Pages/facts.aspx. Sep. 2014
10. P. Pais et al. “Determination of the potency of a novel saw palmetto supercritical CO2 extract (SPSE) for 5α-reductase isoform II inhibition using a cell-free in vitro test system.” Research and Reports in Urology. 8:41-49. 2016.
11. Society of Interventional Radiology. "Nonsurgical treatment turns back the clock, shrinks enlarged prostate." ScienceDaily. ScienceDaily, Accessed: 15 April 2013. Available: www.sciencedaily.com/releases/2013/04/130415124817.htm
12. A. Shrivastava, V. B. Gupta. Various treatment options for benign prostatic hyperplasia: A current update. Journal of Mid-Life Health, 3(1), 10–19. (2012).  http://doi.org/10.4103/0976-7800.98811

Published in WholeFoods Magazine June 2016