Mediterranean diet and prostate cancer risk and mortality in the Health Professionals Follow-up Study
- PMID: 23962747
- PMCID: PMC4157361
- DOI: 10.1016/j.eururo.2013.08.009
Mediterranean diet and prostate cancer risk and mortality in the Health Professionals Follow-up Study
Abstract
Background: Prostate cancer (PCa) mortality rates are lower in the Mediterranean countries compared with northern Europe. Although specific components of the Mediterranean diet (Med-Diet) may influence PCa risk, few studies have assessed the traditional Med-Diet pattern with the risk of incident advanced or lethal PCa or with disease progression among men diagnosed with nonmetastatic PCa.
Objective: To determine whether the traditional Med-Diet pattern is associated with risk of incident advanced or lethal PCa and with PCa-specific and overall mortality among men with PCa.
Design, setting, and participants: We prospectively followed 47 867 men in the Health Professionals Follow-up Study followed from 1986 to 2010. The case-only analysis included 4538 men diagnosed with nonmetastatic PCa, followed from diagnosis to lethal outcome or to January 2010.
Outcome measurements and statistical analysis: We used Cox proportional hazards models to examine traditional and alternative Med-Diet scores in relation to PCa incidence outcomes (advanced and lethal disease). In a case-only survival analysis, we examined postdiagnostic Med-Diet and risk of lethal (metastases or PCa death) and fatal PCa as well as overall mortality among men diagnosed with nonmetastatic disease.
Results and limitations: Between 1986 and 2010, 6220 PCa cases were confirmed. The Med-Diet was not associated with risk of advanced or lethal PCa. In the case-only analysis, there was no association between the Med-Diet after diagnosis and risk of lethal or fatal PCa. However, there was a 22% lower risk of overall mortality (hazard ratio: 0.78; 95% confidence interval, 0.67-0.90; p(trend)=0.0007) among men with greater adherence to the Med-Diet after PCa diagnosis. We found similar associations for the alternative score.
Conclusions: A higher Med-Diet score was not associated with risk of advanced PCa or disease progression. Greater adherence to the Med-Diet after diagnosis of nonmetastatic PCa was associated with lower overall mortality.
Keywords: Epidemiology; Mediterranean diet; Mortality; Prostate cancer; Risk.
Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Comment in
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Can we eat our way to a lower prostate cancer risk, and if so, how?Eur Urol. 2014 May;65(5):895-6. doi: 10.1016/j.eururo.2013.09.017. Epub 2013 Sep 19. Eur Urol. 2014. PMID: 24075579 No abstract available.
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