Effects of Running Distance and Performance on Incident Benign Prostatic Hyperplasia

WILLIAMS, P. T. Effects of Running Distance and Performance on Incident Benign Prostatic Hyperplasia. Med. Sci. Sports Exerc., Vol. 40, No. 10, pp. 1733-1739, 2008. 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.