Purpose: Benign prostatic hyperplasia (BPH) is generally not considered a preventable condition. Our goal is to assess whether running (a vigorous physical activity) and 10-km race performance (an indicator of cardiorespiratory fitness) reduce BPH risk.
Methods: Prospective cohort study of incident BPH in 28,612 nonsmoking, nonvegetarian, nondiabetic men.
Results: The 1899 men (6.64%) reported physician-diagnosed incident BPH during (mean ± SD) 7.74 ± 1.84 yr of follow-up. Survival analyses showed significantly lower risk with both longer distance run (km·wk−1; P < 0.0001) and faster 10-km performance (m·s−1; P = 0.0004) independent of age, BMI, and meat, fish, fruit, and alcohol intake. When adjusted for age, the fastest men (≥4.0 m·s−1) had 32% lower risk than the slowest men (<3 m·s−1; P = 0.0006). The decline in incidence extended throughout the performance range, with even the fastest category (≥4 m·s−1) having significantly lower risk than the penultimate fastest category (3.5-4.0 m·s−1; P = 0.03). The decline in BPH risk with running distance was independent of performance. BPH incidence was more strongly related to the average of the baseline and the follow-up distance run than to concurrent changes in running distance between baseline and follow-up. Incident BPH was significantly lower in men who ran >16 than <16 km·wk−1 (P = 0.05), >32 than 16-32 km·wk−1 (P = 0.02), and >48 than 32-48 km·wk−1 (P = 0.04).
Conclusions: Greater distances run per week may reduce BPH risk independent of BMI, 10-km performance, and diet. If the relationship is causal, then this health benefit accrues at greater exercise doses and intensities than the minimum guideline levels currently recommended.