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Does sugar affect the prostate?

Watch your sugar: A new Johns Hopkins study has shown that your blood sugar has an affect on your prostate. Having high blood sugar is not good for the prostate: in fact, if you have pre-diabetes or diabetes and you get prostate cancer, you are more likely to die from it.

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It’s the holiday season, and we know you’ve got a lot on your mind. One question you’re probably asking yourself: What can I do for my prostate this Thanksgiving? Well, maybe you’re not asking this question, but we’re hoping that both you and your prostate will have a great Thanksgiving, and you can do that by remembering these words: Don’t overdo it. Watch your sugar: A new Johns Hopkins study has shown that your blood sugar has an affect on your prostate. Having high blood sugar is not good for the prostate: in fact, if you have pre-diabetes or diabetes and you get prostate cancer, you are more likely to die from it. But low blood sugar is not good for the prostate, either. This is the finding of a new study, led by epidemiologists at the Brady Urological Institute at Hopkins. “We wanted to understand more about the connections between blood sugar and prostate cancer,” says Corinne Joshu, Ph.D., M.P.H., senior author of the study. With colleagues Michael Marrone, Ph.D., M.P.H., and Elizabeth Platz, Sc.D., M.P.H., she analyzed data from more than 5,000 cancer- free men in the Atherosclerosis in Communities study. They studied three markers for blood sugar in men who did not have diagnosed diabetes: “fasting glucose, hemoglobin A1c, and glycated albumin,” Joshu explains, and worked “to better classify low, normal, and high blood sugar.” Men who were classified with high glycemia (blood sugar) on all three markers had “almost a five times greater risk of dying from prostate cancer,” compared to men who were normal on all three markers. Men with a diabetes diagnosis appeared to have a three-fold or greater risk of dying of prostate cancer – and so did men who did not have diabetes who had low blood sugar. “These patterns were consistent in black men and white men,” notes Joshu. “The results reinforce the importance of efforts to prevent the onset of diabetes,” with weight loss, a healthy diet and exercise, “and to maintain good blood sugar control in men with diabetes – especially in black men, who suffer a disproportionate burden of prostate cancer, hyperglycemia, and diabetes in the U.S.” Don’t pig out. Okay, a show of hands here: Who hasn’t gained weight at least once in your life at the holidays? Anyone? Bueller? We’ve all done it. This is why, for so many Americans, the holidays are followed by a New Year’s resolution to lose weight, which, in turn, is followed by that January repentance and surge in gym attendance that peters out over the next few months. For the prostate, the stakes of overeating are higher. Being overweight is “pretty convincingly associated with being diagnosed with more aggressive disease and death from prostate cancer,” says Joshu’s colleague, Johns Hopkins epidemiologist Elizabeth Platz, Sc.D. “For men who have prostate cancer, being obese and continuing to gain weight is associated with higher disease recurrence and death.” However – and this is good news – as far as prostate cancer is concerned, at every phase of your life, losing weight will help you, and it is never too late to receive a health benefit: If you’re a young man, losing weight might stop the disease from developing. “If a tumor is already there, but very small, and not yet PSA-detectable, losing weight may delay the growth of cancer,” Platz says. “If you have a diagnosis of cancer, losing weight can slow or help prevent the cancer from growing to form metastases” (from spreading to other sites in the body).

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What is it about being overweight and/or not controlling your blood sugar that hurts the prostate? People who are overweight tend to have higher glucose levels, higher insulin levels, and to produce cytokines – immune system boosters, which can encourage inflammation; sometimes inflammation is good, if it helps you fight off infection, but other times, it can put added stress on the body and perhaps tip the balance toward cancer. “We need to understand the biology better, and then maybe if we knew the pathways affected, we could come up with ways to intervene directly,” says Platz. “In the meantime, the better approach is to lose weight, even though it’s hard for many of us to do.” This time of the year, it’s even harder. Have they started bringing holiday candy and baked goods into your workplace yet? This is as much a part of the season as are the big meals themselves. Temptation is everywhere; so are opportunities to just sit around. Says Joshu: “While the holiday season is wonderful for sharing time with family and friends, it is also a time for excess consumption and reduced activity. I recommend that men enjoy this time of year, but also practice moderation in their diet, maintain their physical activity, and avoid weight gain in the upcoming months for a happy and healthy new year.” This doesn’t mean that you have to eat carrot sticks and celery while everyone else is loading up the sweet potato casserole with marshmallows, the green bean casserole, the stuffing, the pumpkin pie, and melt-in-your-mouth rolls dripping with butter. You can have all those things, but watch your portions. Err on the side of vegetables, and do some exercise to burn off those calories. In other words, if you make that resolution before New Year’s Day, your prostate will thank you.

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