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Published in: Journal of General Internal Medicine 8/2020

01-08-2020 | Original Research

A Prospective Study of Physical Activity, Sedentary Behavior, and Incidence and Progression of Lower Urinary Tract Symptoms

Authors: Alison M. Mondul, PhD, Edward Giovannucci, MD, ScD, Elizabeth A. Platz, ScD

Published in: Journal of General Internal Medicine | Issue 8/2020

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Abstract

Background

Lower urinary tract symptoms (LUTS), often secondary to benign prostatic hyperplasia, are a common problem for older men. Lifestyle factors, including physical activity and sedentariness, may be important LUTS risk factors and suitable targets for intervention.

Objective

To determine whether physical activity and sedentariness are associated with LUTS incidence and progression.

Design

The Health Professionals Follow-up Study is a prospective cohort of men that began in 1986. Follow-up for LUTS is complete through 2008.

Participants

Men aged 40–75 years at enrollment and members of health professions.

Main Measures

Total weekly metabolic equivalent of task (MET)-hour scores were calculated and were categorized (< 9, 9 to < 21, 21 to < 42, 42 to < 63, ≥ 63 MET-hours/week). Participants reported their average time/week spent sitting watching television as a measure of sedentariness, which was categorized (< 1, 1–3, 4–10, 11–29, ≥ 30 h/week). Participants completed the International Prostate Symptom Score survey and reported treatments for LUTS periodically. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) of physical activity and television watching with LUTS incidence and progression.

Key Results

After multivariable adjustment, including for body mass index (BMI), men with the highest physical activity were 19% (HR = 0.81, 95% CI = 0.74–0.89; p trend < 0.0001) less likely to develop incident moderate or worse LUTS than men in the lowest category. Men who watched television ≥ 30 h/week were 24% (HR = 1.24, 95% CI = 1.05–1.45; p trend = 0.004) more likely to develop incident moderate or worse LUTS than men who watched < 1 h/week. These associations persisted after mutual adjustment. We observed no associations with LUTS progression.

Conclusions

In this large prospective study, more activity and less sedentariness were associated with lower risk of incident LUTS independent of one another and BMI. Physical inactivity and sedentariness were not associated with LUTS worsening. Increasing physical activity and reducing sedentariness may be strategies for preventing LUTS in addition to their well-established benefits for other diseases.
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Literature
1.
go back to reference Egan KB. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. Urol Clin North Am 2016;43(3):289–97.PubMedCrossRef Egan KB. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. Urol Clin North Am 2016;43(3):289–97.PubMedCrossRef
2.
go back to reference Kirby RS, Kirby M, Fitzpatrick JM. Benign prostatic hyperplasia: counting the cost of its management. BJU Int 2010;105(7):901–2.PubMedCrossRef Kirby RS, Kirby M, Fitzpatrick JM. Benign prostatic hyperplasia: counting the cost of its management. BJU Int 2010;105(7):901–2.PubMedCrossRef
3.
go back to reference Urologic Diseases in America. In: Litwin MS, Saigal CS, eds. Washington, DC: US Government Printing Office: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. 2012. Urologic Diseases in America. In: Litwin MS, Saigal CS, eds. Washington, DC: US Government Printing Office: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. 2012.
4.
go back to reference Silva V, Grande AJ, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev 2019;4:CD012044.PubMed Silva V, Grande AJ, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev 2019;4:CD012044.PubMed
5.
go back to reference Parsons JK, Kashefi C. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol 2008;53(6):1228–35.PubMedCrossRef Parsons JK, Kashefi C. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol 2008;53(6):1228–35.PubMedCrossRef
6.
go back to reference Platz EA, Kawachi I, Rimm EB, Colditz GA, Stampfer MJ, Willett WC, et al. Physical activity and benign prostatic hyperplasia. Arch Intern Med 1998;158(21):2349–56.PubMedCrossRef Platz EA, Kawachi I, Rimm EB, Colditz GA, Stampfer MJ, Willett WC, et al. Physical activity and benign prostatic hyperplasia. Arch Intern Med 1998;158(21):2349–56.PubMedCrossRef
7.
go back to reference Fowke JH, Phillips S, Koyama T, Byerly S, Concepcion R, Motley SS, et al. Association between physical activity, lower urinary tract symptoms (LUTS) and prostate volume. BJU Int 2013;111(1):122–8.PubMedCrossRef Fowke JH, Phillips S, Koyama T, Byerly S, Concepcion R, Motley SS, et al. Association between physical activity, lower urinary tract symptoms (LUTS) and prostate volume. BJU Int 2013;111(1):122–8.PubMedCrossRef
8.
go back to reference Lagiou A, Samoli E, Georgila C, Minaki P, Barbouni A, Tzonou A, et al. Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia. Eur J Cancer Prev 2008;17(4):336–9.PubMedCrossRef Lagiou A, Samoli E, Georgila C, Minaki P, Barbouni A, Tzonou A, et al. Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia. Eur J Cancer Prev 2008;17(4):336–9.PubMedCrossRef
9.
go back to reference Litman HJ, Steers WD, Wei JT, Kupelian V, Link CL, McKinlay JB. Relationship of lifestyle and clinical factors to lower urinary tract symptoms: results from Boston Area Community Health survey. Urology. 2007;70(5):916–21.PubMedPubMedCentralCrossRef Litman HJ, Steers WD, Wei JT, Kupelian V, Link CL, McKinlay JB. Relationship of lifestyle and clinical factors to lower urinary tract symptoms: results from Boston Area Community Health survey. Urology. 2007;70(5):916–21.PubMedPubMedCentralCrossRef
10.
go back to reference Maso LD, Zucchetto A, Tavani A, Montella M, Ramazzotti V, Polesel J, et al. Lifetime occupational and recreational physical activity and risk of benign prostatic hyperplasia. Int J Cancer 2006;118(10):2632–5.CrossRef Maso LD, Zucchetto A, Tavani A, Montella M, Ramazzotti V, Polesel J, et al. Lifetime occupational and recreational physical activity and risk of benign prostatic hyperplasia. Int J Cancer 2006;118(10):2632–5.CrossRef
11.
go back to reference Orsini N, RashidKhani B, Andersson S-O, Karlberg L, Johansson J-E, Wolk A. Long-term physical activity and lower urinary tract symptoms in men. J Urol 2006;176(6):2546–50.PubMedCrossRef Orsini N, RashidKhani B, Andersson S-O, Karlberg L, Johansson J-E, Wolk A. Long-term physical activity and lower urinary tract symptoms in men. J Urol 2006;176(6):2546–50.PubMedCrossRef
13.
go back to reference Wolin KY, Grubb III RL, Pakpahan R, Ragard L, Mabie J, Andriole GL, et al. Physical activity and benign prostatic hyperplasia-related outcomes and nocturia. Med Sci Sports Exerc 2015;47(3):581.PubMedPubMedCentralCrossRef Wolin KY, Grubb III RL, Pakpahan R, Ragard L, Mabie J, Andriole GL, et al. Physical activity and benign prostatic hyperplasia-related outcomes and nocturia. Med Sci Sports Exerc 2015;47(3):581.PubMedPubMedCentralCrossRef
14.
go back to reference Penson DF, Munro HM, Signorello LB, Blot WJ, Fowke JH. Obesity, physical activity and lower urinary tract symptoms: results from the Southern Community Cohort Study. J Urol 2011;186(6):2316–22.PubMedPubMedCentralCrossRef Penson DF, Munro HM, Signorello LB, Blot WJ, Fowke JH. Obesity, physical activity and lower urinary tract symptoms: results from the Southern Community Cohort Study. J Urol 2011;186(6):2316–22.PubMedPubMedCentralCrossRef
15.
go back to reference Park HJ, Park CH, Chang Y, Ryu S. Sitting time, physical activity and the risk of lower urinary tract symptoms: a cohort study. BJU Int 2018;122(2):293–9.PubMedCrossRef Park HJ, Park CH, Chang Y, Ryu S. Sitting time, physical activity and the risk of lower urinary tract symptoms: a cohort study. BJU Int 2018;122(2):293–9.PubMedCrossRef
16.
go back to reference De Nunzio C, Nacchia A, Cicione A, Cindolo L, Gacci M, Cancrini F, et al. Physical Activity as a Protective Factor for Lower Urinary Tract Symptoms in Male Patients: A Prospective Cohort Analysis. Urology. 2019;125:163–8.PubMedCrossRef De Nunzio C, Nacchia A, Cicione A, Cindolo L, Gacci M, Cancrini F, et al. Physical Activity as a Protective Factor for Lower Urinary Tract Symptoms in Male Patients: A Prospective Cohort Analysis. Urology. 2019;125:163–8.PubMedCrossRef
17.
go back to reference Rohrmann S, Katzke VA, Kaaks R. Lifestyle and progression of lower urinary tract symptoms in German men-results from the EPIC-Heidelberg cohort. Urology. 2018;120:192–196. Rohrmann S, Katzke VA, Kaaks R. Lifestyle and progression of lower urinary tract symptoms in German men-results from the EPIC-Heidelberg cohort. Urology. 2018;120:192–196.
18.
go back to reference Ainsworth BE, Haskell WL, Leon AS, Jacobs DR, Jr., Montoye HJ, Sallis JF, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993;25(1):71–80.PubMedCrossRef Ainsworth BE, Haskell WL, Leon AS, Jacobs DR, Jr., Montoye HJ, Sallis JF, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993;25(1):71–80.PubMedCrossRef
19.
go back to reference Keum N, Bao Y, Smith-Warner SA, Orav J, Wu K, Fuchs CS, et al. Association of Physical Activity by Type and Intensity With Digestive System Cancer Risk. JAMA Oncol 2016;2(9):1146–53.PubMedPubMedCentralCrossRef Keum N, Bao Y, Smith-Warner SA, Orav J, Wu K, Fuchs CS, et al. Association of Physical Activity by Type and Intensity With Digestive System Cancer Risk. JAMA Oncol 2016;2(9):1146–53.PubMedPubMedCentralCrossRef
20.
go back to reference Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003;289(14):1785–91.PubMedCrossRef Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003;289(14):1785–91.PubMedCrossRef
22.
go back to reference Platz EA, Joshu CE, Mondul AM, Peskoe SB, Willett WC, Giovannucci E. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. J Urol 2012;188(2):496–501.PubMedPubMedCentralCrossRef Platz EA, Joshu CE, Mondul AM, Peskoe SB, Willett WC, Giovannucci E. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. J Urol 2012;188(2):496–501.PubMedPubMedCentralCrossRef
23.
go back to reference Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol 1992;148:1549–57.PubMedCrossRef Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol 1992;148:1549–57.PubMedCrossRef
24.
go back to reference Rohrmann S, Giovannucci E, Willett WC, Platz EA. Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. Am J Clin Nutr 2007;85:523–9.PubMedCrossRef Rohrmann S, Giovannucci E, Willett WC, Platz EA. Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. Am J Clin Nutr 2007;85:523–9.PubMedCrossRef
25.
go back to reference Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020–8.PubMedCrossRef Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020–8.PubMedCrossRef
26.
go back to reference Giovannucci E. An Integrative Approach for Deciphering the Causal Associations of Physical Activity and Cancer Risk: The Role of Adiposity. J Natl Cancer Inst 2018;110(9):935–41.PubMedCrossRef Giovannucci E. An Integrative Approach for Deciphering the Causal Associations of Physical Activity and Cancer Risk: The Role of Adiposity. J Natl Cancer Inst 2018;110(9):935–41.PubMedCrossRef
27.
go back to reference Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2012;2(2):1143–211.PubMedPubMedCentral Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2012;2(2):1143–211.PubMedPubMedCentral
28.
go back to reference Giovannucci E, Rimm EB, Chute CG, Kawachi I, Colditz GA, Stampfer MJ, et al. Obesity and benign prostatic hyperplasia. Am J Epidemiol 1994;140(11):989–1002.PubMedCrossRef Giovannucci E, Rimm EB, Chute CG, Kawachi I, Colditz GA, Stampfer MJ, et al. Obesity and benign prostatic hyperplasia. Am J Epidemiol 1994;140(11):989–1002.PubMedCrossRef
29.
go back to reference Ficarra V, Rossanese M, Zazzara M, Giannarini G, Abbinante M, Bartoletti R, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep 2014;15(12):463.PubMedCrossRef Ficarra V, Rossanese M, Zazzara M, Giannarini G, Abbinante M, Bartoletti R, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep 2014;15(12):463.PubMedCrossRef
Metadata
Title
A Prospective Study of Physical Activity, Sedentary Behavior, and Incidence and Progression of Lower Urinary Tract Symptoms
Authors
Alison M. Mondul, PhD
Edward Giovannucci, MD, ScD
Elizabeth A. Platz, ScD
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 8/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-05814-1

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