INS and obesity due to melanocortin 4 receptor deficiency: The risk factors for BPH include (a) age [60,65,66,69], (b) smoking (vaping) [69], (c) obesity/overweight [69,72], (d) ↑ insulin [53,57,61,69], (e) ↑ lipids [61,69,72], (f) diabetes [69], (g) hypertension [53,69], (h) depression [69], and (i) a “Western diet.” Conversely, vitamins A, C, D and E along with a “Mediterranean diet” or “Eastern diet” and polyphenols/phytochemicals nutraceutical supplementation with equol, β-sitosterol, pumpkin seed extract, saw palmetto, lycopene, stinging nettle, and green tea are associated with decreased BPH symptoms.