Benign prostatic hyperplasia (BPH) is a condition most men face as they get older, with over half of men in their 60s and nearly 90% of those over 70 experiencing some degree of prostate enlargement. As the prostate grows, it puts pressure on the urethra, leading to lower urinary tract symptoms (LUTS) such as frequent urination, weak or interrupted flow and waking up multiple times at night to urinate (nocturia).1
But is BPH really just an unavoidable consequence of aging? Mounting research proves otherwise and suggests that metabolic syndrome is a major contributor as well. A new study2 published in the journal Aging (Albany NY) sheds new light on this connection, revealing distinct differences in inflammatory markers and metabolic health between men with BPH and those without it.
Are Inflammatory Lipids Driving Prostate Enlargement?
The featured study,3 led by researchers from Poland, examined the role of oxidative stress markers and inflammatory lipid mediators in men with benign prostatic hyperplasia (BPH) to determine whether these markers were significantly different from those in healthy controls.
• Researchers analyzed lipid profiles — The study evaluated 219 men, 144 of whom had BPH and 75 healthy controls, measuring key inflammatory lipids derived from arachidonic acid (AA) and linoleic acid (LA).
These included hydroxyeicosatetraenoic acids (HETEs), hydroxyoctadecadienoic acids (HODEs), prostaglandins, leukotrienes and 5-oxo-eicosatetraenoic acid (5-oxo-ETE), which regulate inflammation, oxidative stress and immune responses.
• BPH patients showed elevated levels of inflammatory lipid markers — The study confirmed that men with BPH had significantly higher levels of lipid mediators that promote inflammation, immune activation and oxidative stress compared to the control group.
Since these markers are derived from omega-6 fats, these findings suggest that consuming foods rich in omega-6 contribute to the inflammatory processes driving prostate enlargement and LUTS.
• 5-Oxo-ETE fuels chronic inflammation and disease progression — One of the most notable findings was the elevated levels of 5-oxo-ETE, a powerful signaling molecule known to activate inflammatory pathways and has been implicated in chronic inflammation, cancer proliferation and metabolic disorders like diabetes. Its increased presence in men with BPH suggests that it plays a broader role in disease progression beyond just prostate enlargement.
• 12-HETE promotes blood vessel growth and oxidative damage — The study found that men with BPH had significantly higher levels of 12-HETE, a molecule known to stimulate angiogenesis, the process of new blood vessel formation.
This is particularly concerning as excessive blood vessel growth in the prostate contributes to tissue expansion and disease progression. Additionally, 12-HETE has been shown to interfere with platelet function, increasing oxidative stress and further worsening inflammation.
• 15-HETE accelerates cell proliferation and fibrosis — Another key inflammatory marker, 15-HETE, was found at elevated levels in BPH patients. This lipid mediator regulates blood vessel function, immune signaling and cell proliferation. Its involvement in fibrosis (the thickening and scarring of tissue) suggests that it contributes to structural changes in the prostate that make BPH more progressive and difficult to reverse.
• 9-HODE is linked to systemic inflammation and chronic disease — The study also found higher levels of 9-HODE, a lipid mediator derived from linoleic acid oxidation. 9-HODE has been linked to oxidative stress and systemic inflammation, and is associated with chronic diseases such as atherosclerosis, Alzheimer’s, diabetes and various cancers.
Its presence in BPH patients suggests that metabolic dysfunction is a driving force behind both prostate enlargement and broader inflammatory conditions.
• The body attempts to counteract inflammation with anti-inflammatory lipids — Interestingly, the researchers found that men with BPH also had increased levels of lipid mediators like resolvins, protectins and maresins, which help resolve inflammation and promote healing.
Resolvin E1, for example, has been shown to protect against inflammatory lung conditions, while maresin 1 aids in clearing out dead immune cells and reducing proinflammatory signaling.
• Inflammatory imbalance drives BPH progression — The presence of both inflammatory and anti-inflammatory lipid mediators suggests that the body is actively trying to regulate inflammation, but the inflammatory burden is too high to resolve. This imbalance explains why BPH continues to progress despite the body’s natural attempts to counteract inflammation.
These findings reinforce the growing evidence that chronic inflammation, driven by dysregulated lipid metabolism, plays a central role in BPH. To understand how excessive omega-6 intake worsens metabolic dysfunction, read “Linoleic Acid — The Most Destructive Ingredient in Your Diet.”
How Does Metabolic Dysfunction Fuel Prostate Inflammation?
Supporting the findings from the Polish study, a December 2024 systematic review published in Life Sciences4 establishes the direct role of metabolic syndrome in BPH by taking a closer look into the underlying molecular pathways. This study highlights how insulin resistance, obesity, hypertension and dyslipidemia contribute to prostate enlargement and LUTS by altering key biological mechanisms.
• BPH is now recognized as a metabolic disease — The study confirms that BPH is a metabolic disorder linked to systemic dysfunction. Prostate enlargement happens when your body’s natural balance between cell growth and cell death is disrupted. This imbalance is driven by long-term issues like insulin resistance, hormone imbalances and chronic inflammation.
• Insulin resistance and IGF-1 activation drive prostate growth — Insulin resistance and high insulin levels cause prostate cells to grow too quickly while preventing the normal process of cell removal, leading to uncontrolled prostate enlargement. This happens because insulin-like growth factor 1 (IGF-1) is activated, encouraging further prostate tissue expansion.
High insulin levels also overstimulate the nervous system, which causes the prostate and bladder muscles to tighten, making urination more difficult and worsening urinary symptoms. Additionally, insulin disrupts the balance between testosterone and estrogen, which leads to hormonal shifts that further contribute to prostate cell overgrowth.
• Obesity-related inflammation and hormones contribute to BPH — The study shows that inflammation caused by obesity and imbalanced fat-cell hormones (adipokines) play a major role in prostate enlargement.
Leptin, a hormone that increases with obesity, stimulates prostate cell growth, while low levels of adiponectin remove your body’s natural protection against inflammation and excessive cell growth. These findings suggest that obesity-related metabolic issues directly contribute to BPH progression.
• Hypertension and the renin-angiotensin system (RAAS) exacerbate BPH — Elevated blood pressure, a key component of metabolic syndrome, is now linked to increased prostate volume and more severe urinary symptoms. This happens because the renin-angiotensin system (RAAS), which helps regulate blood pressure, also affects the prostate by increasing smooth muscle tension. As a result, urinary flow becomes more restricted, making symptoms worse.
To determine how compromised your metabolism is and whether it’s contributing to prostate issues, read “How to Assess Your Metabolic Health at Home.”
Supporting Evidence from Systematic Review and Meta-Analysis
A comprehensive systematic review and meta-analysis published in December 2021 in the journal Therapeutic Advances in Endocrinology and Metabolism5 further supports the direct link between metabolic syndrome and BPH. This large-scale analysis compiled data from 70 studies involving 90,206 patients to evaluate the impact of metabolic syndrome on prostate health and urinary function.
• Men with metabolic syndrome have larger prostates — The meta-analysis confirmed that men with metabolic syndrome had significantly larger total prostate volume (TPV). Data from 30 studies involving 22,206 participants showed that the presence of metabolic syndrome was associated with an average increase of 4.45 milliliters in prostate size.
• Metabolic syndrome increases the risk and severity of LUTS — The study found that men with metabolic syndrome were 1.56 times more likely to develop moderate LUTS and 2.35 times more likely to experience severe LUTS compared to individuals without metabolic dysfunction.
The strongest associations were observed in patients with overactive bladder, with an increased risk of 3.2 times, and those experiencing severe nocturia, who were 2.5 times more likely to wake up multiple times per night to urinate.
• Hypertension and insulin resistance drive prostate enlargement — Among the components of metabolic syndrome, high blood pressure and insulin resistance emerged as the strongest contributors to both increased prostate volume and more severe urinary symptoms.
The study points to RAAS activation as a key factor linking hypertension and BPH progression. Angiotensin II, a hormone involved in blood pressure regulation, has been shown to promote inflammation and cellular proliferation in the prostate, explaining why men with high blood pressure often have more severe LUTS.
• Dyslipidemia and central obesity worsen BPH progression — The study also found that visceral fat accumulation, rather than body mass index (BMI), was a more accurate predictor of LUTS severity. Excess abdominal fat is highly inflammatory and releases cytokines that promote prostate tissue growth.
Additionally, men with high triglycerides and low HDL cholesterol had a significantly greater risk of developing BPH due to increased oxidative stress and lipid peroxidation, which further fuel inflammation and prostate cell proliferation.
The scale of this meta-analysis makes it one of the most comprehensive evaluations of the metabolic syndrome-BPH connection. The consistent findings across multiple datasets confirm that metabolic syndrome is a major, independent risk factor for prostate enlargement and severe urinary symptoms.
More importantly, it shows that metabolic syndrome-related changes can be reliably measured and are clinically significant, emphasizing the need to rethink how BPH is diagnosed and treated.
How Do You Improve Your Metabolic and Prostate Health?
Optimizing metabolic health is key to improving prostate function and overall well-being. By addressing key lifestyle factors, you’ll be able to reduce inflammation, balance hormones and support long-term prostate health. Here are five strategies to get started:
• Manage your stress levels — When you’re constantly on edge, your body pumps out cortisol, a hormone that disrupts insulin sensitivity and fuels inflammation,6 making BPH symptoms worse.7 To lower your stress levels, try mindfulness meditation or breathing techniques.
Emotional Freedom Techniques (EFT), or tapping, is also a powerful tool for stress relief. It uses gentle acupressure on energy meridians to relieve tension and calm your nervous system. Moreover, engaging in creative hobbies like painting, writing or playing music shifts your focus away from stress and boosts your mood. Even something as simple as laughing, hugging a loved one or spending time with pets will help lower stress levels.
• Limit polyunsaturated fat (PUFA) intake — Swap out high-PUFA foods for metabolically stable fats like butter, tallow and coconut oil, which protect cellular integrity and help regulate inflammation. Unlike unstable vegetable oils, these fats resist oxidation, promote hormone balance and provide a steady source of energy without disrupting your metabolism.
• Address estrogen dominance — Excess estrogen contributes to BPH by increasing prostate cell proliferation, altering hormone balance and increasing inflammation.8 Estrogen-mimicking compounds are found in plastics, pesticides, personal care products, tap water and even conventionally raised meats and dairy.
To limit exposure, avoid plastic food containers, choose organic produce and meats whenever possible and switch to cleaner personal care products free of parabens and phthalates. For more tips to lower your estrogen load, check out “Unlocking the Secrets of Hormone Health and Vitality.”
• Improve your gut health — To support your gut, eliminate vegetable oils, ultraprocessed foods, preservatives and artificial additives that disrupt digestion and fuel inflammation. Focus on whole, nutrient-dense foods that are easy to digest, such as well-cooked vegetables, ripe fruits and properly prepared grains.
Fermented foods like kefir, sauerkraut and organic yogurt also help introduce beneficial bacteria, while collagen-rich bone broth and gelatin support gut lining repair. A well-functioning gut improves testosterone metabolism, reduces systemic inflammation and promotes overall metabolic health, making it an essential part of managing BPH.
• Engage in regular physical activity — Increased physical activity has been shown to reduce urinary symptoms, decrease androgen receptors, enhance apoptosis in the prostate and decrease inflammation markers in BPH.9 Prioritizing daily movement, whether through structured workouts, stretching, walking or simply avoiding prolonged sitting, helps maintain both metabolic and prostate health.10
For more strategies on improving metabolic health and making lasting changes for your overall well-being, read “New Year, Real You — The Secret to Lasting Change and a Happier Metabolism.”
Frequently Asked Questions (FAQs) About BPH and Metabolic Health
Q: Is BPH a normal part of aging?
A: No. While BPH becomes more common with age, research shows it’s heavily influenced by metabolic dysfunction and chronic inflammation. Factors like insulin resistance, obesity and poor dietary choices accelerate prostate enlargement and worsen urinary symptoms.
Q: How does metabolic syndrome contribute to prostate enlargement?
A: Metabolic syndrome leads to insulin resistance, which raises insulin and IGF-1 levels, stimulating excessive prostate cell growth. It also increases inflammation and oxidative stress, which in turn damages prostate tissue and disrupts hormonal balance. High triglycerides and oxidized lipids further accelerate inflammation, creating a cycle that worsens BPH.
Q: Can diet affect prostate inflammation and BPH risk?
A: Yes. Diet plays a direct role in hormonal balance, inflammation and lipid metabolism, all of which affect prostate health. Consuming high amounts of omega-6 fats, particularly linoleic acid found in vegetable oils, has been linked to increased inflammation, exacerbating prostate enlargement.
Q: What’s the best way to reduce prostate inflammation naturally?
A: The most effective way to reduce prostate inflammation naturally is by improving metabolic health. Addressing insulin resistance, chronic inflammation, and oxidative stress through diet, exercise and lifestyle changes will help slow prostate enlargement.
