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Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality.
JAMA Intern Med 2013; 173(14):1318-26JIM

Abstract

IMPORTANCE

Nearly 2.5 million men currently live with prostate cancer in the United States, yet little is known about the association between diet after diagnosis and prostate cancer progression and overall mortality.

OBJECTIVE

To examine postdiagnostic fat intake in relation to lethal prostate cancer and all-cause mortality.

DESIGN, SETTING, AND PARTICIPANTS

Prospective study of 4577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study (1986-2010).

EXPOSURES

Postdiagnostic intake of saturated, monounsaturated, polyunsaturated, trans, animal, and vegetable fat.

MAIN OUTCOMES AND MEASURES

Lethal prostate cancer (distant metastases or prostate cancer-specific death) and all-cause mortality.

RESULTS

We observed 315 events of lethal prostate cancer and 1064 deaths (median follow-up, 8.4 years). Crude rates per 1000 person-years for lethal prostate cancer were as follows (highest vs lowest quintile of fat intake): 7.6 vs 7.3 for saturated, 6.4 vs 7.2 for monounsaturated, 5.8 vs 8.2 for polyunsaturated, 8.7 vs 6.1 for trans, 8.3 vs 5.7 for animal, and 4.7 vs 8.7 for vegetable fat. For all-cause mortality, the rates were 28.4 vs 21.4 for saturated, 20.0 vs 23.7 for monounsaturated, 17.1 vs 29.4 for polyunsaturated, 32.4 vs 17.1 for trans, 32.0 vs 17.2 for animal, and 15.4 vs 32.7 for vegetable fat. Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001). No other fats were associated with lethal prostate cancer. Saturated and trans fats after diagnosis (replacing 5% and 1% of energy from carbohydrate, respectively) were associated with higher all-cause mortality (HR, 1.30 [95% CI, 1.05-1.60; P = .02] and 1.25 [95% CI, 1.05-1.49; P = .01], respectively).

CONCLUSIONS AND RELEVANCE

Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality. The potential benefit of vegetable fat for prostate cancer-specific outcomes merits further research.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA. richmane@urology.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23752662

Citation

Richman, Erin L., et al. "Fat Intake After Diagnosis and Risk of Lethal Prostate Cancer and All-cause Mortality." JAMA Internal Medicine, vol. 173, no. 14, 2013, pp. 1318-26.
Richman EL, Kenfield SA, Chavarro JE, et al. Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality. JAMA Intern Med. 2013;173(14):1318-26.
Richman, E. L., Kenfield, S. A., Chavarro, J. E., Stampfer, M. J., Giovannucci, E. L., Willett, W. C., & Chan, J. M. (2013). Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality. JAMA Internal Medicine, 173(14), pp. 1318-26. doi:10.1001/jamainternmed.2013.6536.
Richman EL, et al. Fat Intake After Diagnosis and Risk of Lethal Prostate Cancer and All-cause Mortality. JAMA Intern Med. 2013 Jul 22;173(14):1318-26. PubMed PMID: 23752662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality. AU - Richman,Erin L, AU - Kenfield,Stacey A, AU - Chavarro,Jorge E, AU - Stampfer,Meir J, AU - Giovannucci,Edward L, AU - Willett,Walter C, AU - Chan,June M, PY - 2013/6/12/entrez PY - 2013/6/12/pubmed PY - 2013/9/28/medline SP - 1318 EP - 26 JF - JAMA internal medicine JO - JAMA Intern Med VL - 173 IS - 14 N2 - IMPORTANCE: Nearly 2.5 million men currently live with prostate cancer in the United States, yet little is known about the association between diet after diagnosis and prostate cancer progression and overall mortality. OBJECTIVE: To examine postdiagnostic fat intake in relation to lethal prostate cancer and all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 4577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study (1986-2010). EXPOSURES: Postdiagnostic intake of saturated, monounsaturated, polyunsaturated, trans, animal, and vegetable fat. MAIN OUTCOMES AND MEASURES: Lethal prostate cancer (distant metastases or prostate cancer-specific death) and all-cause mortality. RESULTS: We observed 315 events of lethal prostate cancer and 1064 deaths (median follow-up, 8.4 years). Crude rates per 1000 person-years for lethal prostate cancer were as follows (highest vs lowest quintile of fat intake): 7.6 vs 7.3 for saturated, 6.4 vs 7.2 for monounsaturated, 5.8 vs 8.2 for polyunsaturated, 8.7 vs 6.1 for trans, 8.3 vs 5.7 for animal, and 4.7 vs 8.7 for vegetable fat. For all-cause mortality, the rates were 28.4 vs 21.4 for saturated, 20.0 vs 23.7 for monounsaturated, 17.1 vs 29.4 for polyunsaturated, 32.4 vs 17.1 for trans, 32.0 vs 17.2 for animal, and 15.4 vs 32.7 for vegetable fat. Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001). No other fats were associated with lethal prostate cancer. Saturated and trans fats after diagnosis (replacing 5% and 1% of energy from carbohydrate, respectively) were associated with higher all-cause mortality (HR, 1.30 [95% CI, 1.05-1.60; P = .02] and 1.25 [95% CI, 1.05-1.49; P = .01], respectively). CONCLUSIONS AND RELEVANCE: Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality. The potential benefit of vegetable fat for prostate cancer-specific outcomes merits further research. SN - 2168-6114 UR - https://www.unboundmedicine.com/medline/citation/23752662/Fat_intake_after_diagnosis_and_risk_of_lethal_prostate_cancer_and_all_cause_mortality_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2013.6536 DB - PRIME DP - Unbound Medicine ER -