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Fasting, Hormones, and Men’s Sexual Health
As the pioneer and global leader of Functional Medicine, the Institute of Functional Medicine leads and catalyses the efforts of a large and expanding Functional Medicine ecosystem, including providers, educators, payers, industry leaders, regulators, and influencers.
2023
Abstract
IFM practitioner Mark Holthouse discusses male hormone dysregulation, specifically low testosterone and the impact that this might have on men’s sexual health and function. They explore lifestyle factors such as stress, sleep and body composition on testosterone levels; the metabolic pathways that might lower testosterone such as intestinal permeability, insulin resistance and aromatase upregulation, and how to mitigate this via intermittent fasting, phytonutrient intake and strength training to name a few.
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Effect of Tart Cherry on Aromatase Inhibitor-Induced Arthralgia (AIA) in Nonmetastatic Hormone-Positive Breast Cancer Patients: A Randomized Double-Blind Placebo-Controlled Trial.
Shenouda, M, Copley, R, Pacioles, T, Lebowicz, Y, Jamil, M, Akpanudo, S, Tirona, MT
Clinical breast cancer. 2022;22(1):e30-e36
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Aromatase inhibitors (AIs) are used as a treatment in breast cancer; however, a side effect of their use is often the development of aromatase inhibitor induced arthralgia (AIA), which manifests as pain in the joints, muscle weakness and reduced grip strength. Subsequently, many individuals stop taking AIs, resulting in poorer disease prognosis. Tart cherries (TC) have been shown in studies to help relieve joint pain and pain associated with exercise and so this RCT aimed to determine the effect of TC consumption on 60 breast cancer patients with AIA. The results showed that after 6-weeks individuals given TC had less pain, with some individuals reporting no pain at all. It was concluded that TC is a reliable and safe option for the management of AIA in breast cancer patients. This study could be used by healthcare professionals to recommend TC as an adjunct to aromatase inhibitor therapy in individuals with breast cancer who are experiencing pain.
Abstract
BACKGROUND Aromatase Inhibitor induced Arthralgia (AIA) can cause noncompliance leading to decreased breast-cancer survival. Effective interventions for AIA are limited. Tart cherry (TC) showed beneficial effect on musculoskeletal pain. 48 patients (Pts) randomized to TC versus placebo over 6 weeks, TC (23pts) had 34.7% mean pain decrease versus 1.4% in Placebo (25pts). TC can improve AIA in nonmetastatic breast-cancer patients. METHODS Randomized, placebo-controlled, double-blind trial. Eligible patients with NMHPBC on AI for at least 4 weeks were randomized to TC concentrate [50 tart cherries] vs. placebo (P) [syrup] in 1:1 model. Patients instructed to consume 1 Oz of concentrate in 8 Oz water daily for 6 weeks, and document their pain intensity at baseline, weekly and at study completion in a diary using Visual Analog Scale (VAS), with 0 mm indicating no pain, and 100 mm indicating highest pain. RESULTS Sixty patients were enrolled. Two patients did not complete the study due to diarrhea, and 10 patients were noncompliant. Forty-eight patients were included in the final analysis. TC group (23 pts) had 34.7% mean decrease in pain compared to 1.4% in P group (25 pts). This difference was statistically significant (Mann-Whitney U Test, P = .034). CONCLUSIONS Tart cherry can significantly improve AIA in nonmetastatic breast cancer patient.
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Manipulation of Dietary Intake on Changes in Circulating Testosterone Concentrations.
Zamir, A, Ben-Zeev, T, Hoffman, JR
Nutrients. 2021;13(10)
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Androgens, like testosterone, are steroid hormones commonly associated with reproduction. However, they also govern metabolic functions, body composition and growth. Higher levels of circulating androgens enhance athletic performance by supporting metabolic activities such as protein production, regeneration and growth and by inhibiting breakdown processes. Manipulating testosterone to enhance athletic performance without the use of anabolic steroids hormones has been of much interest. As macro-and micronutrients can influence androgen hormones, this review examined whether specific energy and nutrient intake can ‘naturally’ manipulate testosterone levels. The authors describe the metabolic functions of testosterone before exploring the current evidence on selected plant extracts and nutrients and their impact on aromatase activity. Inhibiting aromatase can prevent androgens from being converted into oestrogen and thus may help to raise circulating androgens. Discussed are a range of plant-derived compounds, flavonoids, macronutrients and micronutrients (Vitamin D, Zinc and Magnesium) and their impact on testosterone levels. The authors conclude that the nutrients discussed have some supportive evidence, yet overall findings are inconclusive due to limited studies. Regarding macronutrients more research is available, and the evidence supports that low energy intake negatively impacts testosterone levels and performance. Whereby supplementation of vitamins crucial to testosterone production seems to provide value in cases of deficiency further research is required. This article yields an overview of plant compounds, macro-and micronutrients and their potential impact on circulating testosterone levels. While low energy intake and nutrient deficiencies appears to be unfavourable, the absence of clear evidence on other compounds would warrant further case-specific investigations.
Abstract
Elevations in the circulating concentration of androgens are thought to have a positive effect on the anabolic processes leading to improved athletic performance. Anabolic-androgenic steroids have often been used by competitive athletes to augment this effect. Although there has been concerted effort on examining how manipulating training variables (e.g., intensity and volume of training) can influence the androgen response to exercise, there has been much less effort directed at understanding how changes in both macronutrient and micronutrient intake can impact the androgen response. Thus, the focus of this review is to examine the effect that manipulating energy and nutrient intake has on circulating concentrations of testosterone and what the potential mechanism is governing these changes.
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The impact of nutrition and lifestyle on male fertility.
Benatta, M, Kettache, R, Buchholz, N, Trinchieri, A
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2020;92(2)
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The impact of environmental, lifestyle and nutritional factors on unexplained male fertility has long been acknowledged. Yet, little research had been dedicated to the topic, despite declining semen quality having become a worldwide phenomena. Available studies have yielded limited, and at times conflicting, evidence. Hence this literature review sought to capture the current knowledge around unexplained male infertility and environmental, lifestyle, diet and nutrients factors. Summarized is the evidence from 69 studies, including population observations and clinical trials. The collected outcomes showed that a Western-type diet, rich in red and processed meats, refined grains, high-energy drinks and sweets, trans and saturated fats was associated with poor semen quality. Whereby higher intakes of fruits and vegetables, whole grains, omega-3 and poultry showed beneficial effects. However, as only selected groups were examined, more research is needed to project such findings onto the wider population. The reviewed evidence also included alcohol consumption, which showed high alcohol intake closely correlated to declining sperm concentrations. Whilst the verdict on caffeine consumption and the impact on sperm quality was inconclusive. In addition, several interventional studies evaluated the effect of dietary supplementation on various parameters of semen, where coenzyme Q10, L-carnitine, vitamin E, antioxidants, combined nutrient formulations and herbal blends all had positive outcomes. The review on zinc and folic acid supplementation yielded mixed results. This brief recap of the current evidence on environmental, lifestyle and nutritional influences on male infertility summarises the dietary foundations for the support of unexplained male infertility.
Abstract
BACKGROUND AND AIMS Male unexplained infertility has long been suspected to result from environmental, lifestyle and nutritional factors. However, the literature on the subject is still scarce, and clinical studies providing robust evidence are even scarcer. In addition, some similar studies come to different conclusions. Dietary pattern can influence spermatogenesis by its content of fatty acids and antioxidants. Yet, in an age of industrialized mass food production, human bodies become more exposed to the ingestion of xenobiotics, as well as chemicals used for production, preservation, transportation and taste enhancement of foods. We attempted in this paper to collect the available evidence to date on the effect of nutritional components on male fertility. MATERIAL AND METHODS A systematic search of the relevant literature published in PubMed, ScienceDirect and Cochrane Central Register of Controlled Trials Database was conducted. Literature was evaluated according to the Newcastle-Ottawa- Scale. RESULTS Epidemiological observations are concordant in demonstrating an association of low-quality sperm parameters with higher intake of red meat, processed and organ meat and fullfat dairy. On the contrary, better semen parameters were observed in subjects consuming a healthy diet, rich in fruit, vegetables, whole grains and fish. Evidences of the negative impact on male fertility of by-products of water disinfection, accumulation in food chain of persistent organochlorine pollutants, pesticides, phthalates from food and water containers and hormones used in breeding cattle have been reported. Clinical trials of the effects of micronutrients on semen parameters and outcomes of assisted fertilization are encouraging, although optimal modality of treatment should be established. CONCLUSIONS Although quality of evidence should be ameliorated, it emerges that environmental factors can influence male fertility. Some nutrients may enhance fertility whereas others will worsen it. With diagnostic analysis on a molecular or even sub-molecular level, new interactions with micronutrients or molecular components of our daily ingested foods and leisure drugs may lead to a better understanding of so far suspected but as yet unexplained effects on male spermatogenesis and fertility.
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The impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy: a randomized controlled trial.
Paulo, TRS, Rossi, FE, Viezel, J, Tosello, GT, Seidinger, SC, Simões, RR, de Freitas, R, Freitas, IF
Health and quality of life outcomes. 2019;17(1):17
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Aromatase inhibitors (which include Tamoxifen) are considered the gold standard treatment in postmenopausal women with breast cancer but may lead to symptoms which have a negative effect on quality of life (QoL). The aim of this randomised controlled study was to evaluate the effect of exercise on QoL in older breast cancer survivors undergoing aromatase inhibitor therapy. 36 women took part in the study, 18 in the exercise group (EX) and 18 in the control group (CN). The EX group attended three supervised exercise sessions per week, consisting of a combination of aerobic and resistance exercise. The CN group attended two relaxation and stretching classes a week. Study duration was nine months. Three different questionnaires were used to assess various aspects of QoL. The study found that combined aerobic and resistance exercise can significantly improve almost all aspects of QoL, including physical, psychological and social functioning. The authors conclude that a combination of aerobic and resistance exercise could be an important strategy to improve health and minimise the side effects of breast cancer treatment in breast cancer survivors.
Abstract
BACKGROUND This study evaluated the impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy. METHODS Older breast cancer survivors were randomized into two groups: combined training: resistance + aerobic exercise program for nine months (n = 18) or control group (n = 18). Quality of life was assessed by the questionnaires SF36, EORTC QLQ-C30, and EORTC QLQ-BR23 at baseline, and at three, six, and nine months. The exercise group performed 40 min of resistance exercises on machines followed by 30 min of aerobic training on a treadmill 3x/wk. Repeated measures ANOVA was used to compare the groups over time. RESULTS Significant time x group interactions and moderate to high effect sizes were found for physical functioning, physical health, bodily pain, general health perception, vitality, social functioning, fatigue, sleep disturbance, body image, and upset by hair loss, favoring the exercise group. CONCLUSION This study demonstrated the potential benefits and high clinical relevance of exercise programs to improve quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy.