Healthy diet ‘a concrete step’ to reduce risk for prostate cancer progression
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Key takeaways:
- A high-quality diet may reduce likelihood of grade reclassification for men with prostate cancer undergoing active surveillance.
- Researchers hope to analyze factors that may affect the impact of diet.
Greater adherence to American dietary guideline recommendations appeared linked with reduced likelihood of prostate cancer progression among men undergoing active surveillance, study results showed.
Researchers noted several possible risk-lowering mechanisms due to the consumption of a higher-quality diet, including lower inflammation potential.
“Improving the quality of your overall diet is a concrete step that a man in active surveillance can take to reduce the risk of his tumor worsening,” Bruce J. Trock, PhD, MPH, Frank Hinman Jr. endowed professor of urology, as well as professor of oncology and epidemiology at Johns Hopkins School of Medicine, told Healio. “Although we know that major changes in diet aren’t easy, any improvements may help, such as increasing vegetable and whole grain intake, and decreasing sugar, alcohol and saturated fats. Paying attention to food labels helps here. These kinds of dietary changes also reduce risk for cardiovascular disease, diabetes and obesity.”
Trock and colleagues conducted a prospective cohort study to assess whether diet may influence risk for prostate cancer grade reclassification among men who opted for active surveillance.
The analysis included 886 men (median age at diagnosis, 66 years) diagnosed with grade group 1 prostate cancer between January 2005 and February 2017.
Men completed a validated food frequency questionnaire on their usual dietary patterns.
Median follow-up was 6.5 years.
Researchers used competing risk regression scores to test baseline Healthy Eating Index 1999-2000 (HEI) and energy-adjusted HEI (E-HEI) scores to measure patients’ adherence to the Dietary Guidelines for Americans. They used dietary inflammatory index (DII) and energy-adjusted DII (E-DII) scores to assess the potential association with grade reclassification.
About one in five men (21%) had grade reclassification to grade group 2 or greater. Also, 6% had grade reclassification to grade group 3 or greater, which investigators classified as “extreme grade reclassification.”
Researchers reported a cumulative incidence of grade reclassification of 7% (95% CI, 5-9) at 3 years, 15% (95% CI, 12-17) at 5 years and 33% (95% CI, 29-37) at 10 years.
They reported extreme grade reclassification to be 2% (95% CI, 1-4) at 3 years, 4% (95% CI, 3-5) at 5 years and 10% (95% CI, 7-13) at 10 years.
Higher baseline HEI (subdistribution HR [SHR] = 0.85; 95% CI, 0.73-0.98) and E-HEI (SHR = 0.86; 95% CI, 0.74-1) per 1 standard deviation increase in score appeared associated with a significantly lower risk for grade reclassification, according to researchers.
Higher baseline HEI (SHR = 0.72; 95% CI, 0.57-0.93) and E-HEI (SHR = 0.73; 95% CI, 0.57-0.94) per 1 standard deviation increase in score appeared associated with a lower risk for extreme grade reclassification.
Researchers observed no associations between baseline DII or E-DII and grade reclassification.
“We weren’t surprised, and the magnitude of effect was in line with what we expected,” Trock told Healio. “Generally, to detect statistically significant effects of this magnitude requires large studies that follow the men for a sufficient number of years, and we thought our study size and average length of follow-up would be sufficient to detect whether the HEI effects grade reclassification.”
Moving forward, Trock and colleagues want to evaluate whether the effect of the HEI varies based on age, BMI, physical activity, family history, and use of NSAIDs or other medications.
“We also have extensive serum samples and biopsy tissue from these men, so we would like to evaluate how the HEI influences activation of certain genes and the microbiome,” Trock said.
For more information:
Bruce J. Trock, PhD, MPH, can be reached at btrock@jhmi.edu.
References:
- John Hopkins Medicine. Study suggests a healthy diet may help keep low grade prostate cancer from progression to more dangerous states during active surveillance (press release). Available at: https://www.hopkinsmedicine.org/news/newsroom/news-releases/2024/10/study-suggests-a-healthy-diet-may-help-keep-low-grade-prostate-cancer-from-progressing-to-more-dangerous-states-during-active-surveillance. Published Oct. 17, 2024. Accessed Nov. 5, 2024.
- Su ZT, et al. JAMA Oncol. 2024;doi:10.1001/jamaoncol.2024.4406.
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