Western diet associated with increased risk of aggressive prostate cancer

Adherence to a Western dietary pattern was linked to an increased risk of developing aggressive prostate cancer, according to new findings from the Spanish cohort of the EPIC study.^1,2

Investigators found no effect on prostate cancer risk for men who adhered to a Prudent or Mediterranean diet.

The study, which was published in BJU International, also showed, however, that following a healthy diet was not associated with a lower overall risk of developing prostate cancer.

“Our results indicate that avoiding unhealthy dietary habits could be the best nutritional strategy to prevent aggressive prostate cancer,” said lead author Adela Castelló-Pastor, PhD, in a news release on the findings.² Castelló-Pastor is an investigator at the Carlos III Institute of Health and CIBERESP in Spain.

The multicentric, prospective study assessed the dietary habits of 15,296 men from 1992-1996. Diets were categorized as Western, Prudent, or Mediterranean. Western diets consisted of high intakes of high-fat dairy products, processed meats, refined grains, sweets, caloric drinks, convenience food and sauces, and low intakes of whole grains. Prudent diets consisted of high intakes of low-fat dairy products, vegetables, fruits, whole grains, and juices. Mediterranean diets consisted of high intakes of fish, vegetables, legumes, boiled potatoes, fruits, olives, vegetable oil, and low intakes of juices.

Among all patients, the study authors observed 609 cases of prostate cancer during a median follow-up time of 17 years. Physical activity, lifetime alcohol intake, and smoking were taken into account for analysis.

Investigators found no effect on prostate cancer risk for men who adhered to a Prudent or Mediterranean diet. However, a negative effect was observed for men with moderate to high adherence to a Western-style dietary pattern (P = .074). This association was only observed for men with aggressive disease, defined as Gleason grade group > 6 and ISUP grade 3 to 5.

Higher alcohol intake was observed in men who were in the second to fourth quartiles of adherence to a Western diet. Men in the fourth quartile of adherence to the Western diet also had a higher energy intake, were more likely to be current smokers, were younger, and less likely to have a higher education level.

High adherence to the Prudent diet was associated with lower alcohol intake, lower BMI, younger age at recruitment, lower physical activity, non-smoking, and higher energy intake and education level. High adherence to the Mediterranean diet was associated with higher alcohol and energy intake, slightly lower BMI, younger age, a more active lifestyle, higher levels of education, and less smoking.

“Our study suggests that high adherence to the Mediterranean diet, characterized by high intake of whole fruits (not juice), vegetables, legumes, whole grains, nuts, vegetable oils or fish, is not enough to prevent prostate cancer. Additionally, it suggests the intake of foods representative of the Western diet, such as high-fat dairy products, red and processed meats, refined grains, sweets, caloric drinks, convenience food and sauces, should be reduced to prevent this disease,” the authors wrote in their study conclusion.

References

1. Castelló A, Rodríguez-Barranco, M, Pérez-Gómez B, et al. High adherence to Western dietary pattern and prostate cancer risk: findings from the EPIC-Spain cohort [published online ahead of print April 19, 2023]. BJU Int. doi: 10.1111/bju.16001

2. Can a healthy diet prevent prostate cancer? News release. April 19, 2023. Accessed April 24, 2023. https://johnwiley2020news.q4web.com/press-releases/press-release-details/2023/Can-a-healthy-diet-prevent-prostate-cancer/default.aspx