Abstract
The underlying reasons for the increasing occurrence of male reproductive diseases (MRD) such as hypospadias, cryptorchidism, and testicular cancer (TC) over the last decades are still unknown. It has been hypothesized that the risk of MRD is determined in utero and that pregnancy dietary intake could also affect MRD risk in the offspring. Various studies in animals reported that cocoa and theobromine, the main stimulant of cocoa, exert toxic effects on the testis, inducing testicular atrophy and impaired sperm quality. A correlation analysis was conducted to examine the possible role of cocoa consumption on the occurrence of selected MRD during the prenatal and early life period of cases. The incidence rates between 1998–2002 of TC in 18 countries obtained from Cancer Incidence in Five Continents were correlated with the average per-capita consumption of cocoa (kg/capita/year) (FAOSTAT-Database) in these countries from 1965 to 1980, i.e. the period corresponding to the early life of TC cases. In order to test the above correlation in the case of hypospadias, the mean prevalence at birth in 20 countries (1999–2003) with average per-capita consumption of cocoa in these countries in the same period corresponding to pregnancy were used. The consumption of cocoa in the period 1965–80, was most closely correlated with the incidence of TC in young adults (r=0.859; p<0.001). An analogous significant correlation was also observed between early cocoa consumption and the prevalence rates of hypospadias in the period 1999–2003 (r=0.760; p<0.001). Although the ecological approach used in this study cannot provide an answer on the causal relationship between consumption of cocoa in early life and TC and hypospadias, the results are suggestive and indicate the need of further analytic studies to investigate the role of individual exposure to cocoa, particularly during the prenatal and in early life of the patients.
Highlights
Male reproductive tract diseases (MRD) such as hypospadias, cryptorchidism, and testicular cancer (TC) have been increasing for at least 40 years in the developed countries
The ecological approach used in this study cannot provide an answer on the causal relationship between consumption of cocoa in early life and TC and hypospadias, the results are suggestive and indicate the need of further analytic studies to investigate the role of individual exposure to cocoa, during the prenatal and in early life of the patients
Analysing cocoa beans consumption trends in selected developed countries in the last 40 years, we observed a steady increase of 1% per year, that seems to be consistent with the parallel increases in the incidence of TC and other male reproductive diseases registered in the same period [3]
Summary
Male reproductive tract diseases (MRD) such as hypospadias, cryptorchidism, and testicular cancer (TC) have been increasing for at least 40 years in the developed countries. TC is currently the most diagnosed malignancy in men aged 20-34 years and its incidence in some countries has risen 3-fold over the last decades [1,2,3]. These male developmental disorders have been proposed to comprise a common underlying syndrome with a common aetiology resulting from the disruption of embryonic programming and gonadal development during fetal life, termed Testicular Dysgenesis. Similar trends have been observed in other European countries [8,9]
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