Lycopene

Lycopene is sold as a «vascular health support» on the back of observational data linking the Mediterranean diet with lower cardiovascular risk. Randomised controlled trials of isolated lycopene do not show a significant reduction in cardiovascular events. EFSA 2011 rejected health claims for lycopene and protection of LDL from oxidation – the evidence base did not meet the regulatory threshold. ESC 2021 builds primary prevention on SCORE2, BP, lipid and glucose control and Mediterranean diet; in that framework tomatoes appear as ordinary food, not as a supplement. Regular consumption of tomatoes and tomato paste with olive oil is useful and safe; high-dose lycopene capsules are marketing.

Lycopene is the flagship supplement in the «tomatoes protect against prostate cancer» narrative. Observational studies in Mediterranean populations did link high tomato intake to lower prostate cancer rates. Randomised controlled trials did not confirm the signal: the FDA systematic review by Kavanaugh 2007 found «very limited evidence», and the Cochrane review by Ilic 2011 did not confirm a risk reduction with lycopene supplements. EFSA rejected all lycopene health claims in 2011 and 2014, including «prostate protection». SEOM 2024 and AUA 2023 do not include lycopene in primary prostate cancer prevention. For men over 50, shared decision-making about PSA screening with a urologist, smoking cessation and obesity control are the relevant actions – not a lycopene supplement.

Lycopene is heavily marketed as a «prostate health support» for benign prostatic hyperplasia. No quality RCTs with urological endpoints (IPSS, post-void residual volume, flow rate) exist – only small trials with conflicting results. EFSA 2011 rejected health claims linking lycopene to prostate function. EAU 2024 and AEU 2023 do not include lycopene in BPH algorithms: the first line consists of alpha-blockers (tamsulosin, silodosin), 5-alpha-reductase inhibitors (finasteride, dutasteride) and, when indicated, PDE-5 inhibitors (tadalafil). Lower urinary tract symptoms require in-person urology assessment with PSA and ultrasound, not self-prescribed lycopene from iHerb.