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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.

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  • Authors+Show Affiliations

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Electronic address: KenfieldS@urology.ucsf.edu.

    ,

    Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.

    ,

    Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

    ,

    Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

    Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.

    Source

    European urology 65:5 2014 May pg 887-94

    MeSH

    Adult
    Aged
    Diet, Mediterranean
    Follow-Up Studies
    Health Personnel
    Humans
    Incidence
    Male
    Middle Aged
    Patient Compliance
    Proportional Hazards Models
    Prospective Studies
    Prostatic Neoplasms
    Risk Factors
    United States

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    23962747

    Citation

    Kenfield, Stacey A., et al. "Mediterranean Diet and Prostate Cancer Risk and Mortality in the Health Professionals Follow-up Study." European Urology, vol. 65, no. 5, 2014, pp. 887-94.
    Kenfield SA, DuPre N, Richman EL, et al. Mediterranean diet and prostate cancer risk and mortality in the Health Professionals Follow-up Study. Eur Urol. 2014;65(5):887-94.
    Kenfield, S. A., DuPre, N., Richman, E. L., Stampfer, M. J., Chan, J. M., & Giovannucci, E. L. (2014). Mediterranean diet and prostate cancer risk and mortality in the Health Professionals Follow-up Study. European Urology, 65(5), pp. 887-94. doi:10.1016/j.eururo.2013.08.009.
    Kenfield SA, et al. Mediterranean Diet and Prostate Cancer Risk and Mortality in the Health Professionals Follow-up Study. Eur Urol. 2014;65(5):887-94. PubMed PMID: 23962747.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Mediterranean diet and prostate cancer risk and mortality in the Health Professionals Follow-up Study. AU - Kenfield,Stacey A, AU - DuPre,Natalie, AU - Richman,Erin L, AU - Stampfer,Meir J, AU - Chan,June M, AU - Giovannucci,Edward L, Y1 - 2013/08/13/ PY - 2013/06/21/received PY - 2013/08/01/accepted PY - 2013/8/22/entrez PY - 2013/8/22/pubmed PY - 2014/11/18/medline KW - Epidemiology KW - Mediterranean diet KW - Mortality KW - Prostate cancer KW - Risk SP - 887 EP - 94 JF - European urology JO - Eur. Urol. VL - 65 IS - 5 N2 - 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. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/23962747/Mediterranean_diet_and_prostate_cancer_risk_and_mortality_in_the_Health_Professionals_Follow_up_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(13)00830-0 DB - PRIME DP - Unbound Medicine ER -