Best Diet To Prevent Prostate Cancer

Written by Dr. Steve Chaney on . Posted in diet and prostate cancer

Reducing Your Risk Of Developing Aggressive Prostate Cancer

Author: Dr. Stephen Chaney

 

best diet to prevent prostate cancerIs there a best diet to prevent prostate cancer?

Prostate cancer is like a tale of two entirely different cancers. For most men, prostate cancer is both inevitable and relatively benign. For example, in one study scientists performed a histological examination of the prostate in men who had died of other causes. They reported detecting prostate cancer in 28% of men who died at age 30-39 and 75% of men who died at age 85. That has lead to the oft-quoted saying: “Most men die with prostate cancer rather than from prostate cancer.”

However, in a small percentage of cases, the prostate cancer turns aggressive and becomes a killer. And, there is some evidence that the incidence of aggressive prostate cancer is increasing. It is this aggressive form of prostate cancer that we want to avoid.

The prevention of aggressive prostate cancer has been controversial. The clinical studies have been conflicting. In part, that is because many of the previous studies did not distinguish between benign and aggressive prostate cancer.

More recent studies have focused specifically on the most aggressive forms of prostate cancer. These studies have provided greater clarity. I will summarize the American Cancer Society’s recommendations of foods to eat and foods to avoid below.

However, while the American Cancer Society’s recommendations are helpful, it is more useful to focus on the overall diet rather than individual foods. The current study (A. Castello et al, The Journal Of Urology, 199: 430-437, 2018) does just that. It compares the effect of the Western Diet, a Prudent Diet, and the Mediterranean diet on the risk of developing aggressive prostate cancer.

What is the best diet to prevent prostate cancer?

How Was The Study Done?

best diet to prevent prostate cancer studyThis study was part of the Multicase-Controlled Study On Common Tumors in Spain (MCC-Spain) program. MCC-Spain was conducted in 7 Spanish provinces between September 2008 and December 2013. From this larger population base the authors selected 754 subjects with histologically confirmed prostate cancer and 1,277 matched controls. The ages of men included in this study ranged from 38 to 85 years old.

All the participants in this study participated in an extensive computerized questionnaire to gather information on sociodemographic and lifestyle factors, personal and family medical history, height and weight. The questionnaire included a detailed food frequency questionnaire to assess their diet over the previous year. These questionnaires were administered by trained personnel in face-to-face interviews to assure accuracy.

The authors used a program they had developed previously to analyze the food frequency information and calculate the subject’s adherence to 3 different diets. These diets were:

  • The Western Diet: This diet is characterized by a high intake of high-fat dairy products, refined grains, processed and red meats, caloric drinks, sweets, convenience foods and sauces, and by a low intake of low-fat dairy products, whole grains, vegetables and fruits.
  • The Prudent Diet: This diet is characterized by low-fat dairy products, whole grains, vegetables, fruits, and juices. This is essentially a lacto-ovo-vegetarian diet, which has been shown to reduce the risk of some cancers.
  • The Mediterranean Diet: This diet is characterized by a high intake of fish, boiled potatoes, vegetables, legumes, fruits, whole grains, vegetable oil and olives.

The study compared the adherence to each of these diets to the risk of developing an aggressive form of prostate cancer. Two independent assays were used to identify aggressive tumors.

Best Diet To Prevent Prostate Cancer

 

best diet to prevent prostate cancer foodsThe results of the study were as follows:

  • High adherence to the Western diet tended to increase the risk of aggressive prostate cancer. However, the results were not statistically significant, possibly due to the small number of participants with high adherence to a Western diet in this population.
  • High adherence to the Prudent diet had no effect on aggressive prostate cancer risk, although it does decrease the risk of some cancers.
  • High adherence to the Mediterranean diet decreased the risk of aggressive prostate cancer between 32% and 51% depending on the assay used to identify aggressive tumors.

While the authors preferred to focus on whole diets rather than individual foods, they pointed out that the biggest differences between the Mediterranean diet and the Prudent diet were increased consumption of fish and olives and decreased consumption of dairy. They considered the difference in fish consumption to be the most significant difference.

The authors cited previous studies showing that while fish consumption had no effect on prostate cancer incidence, it did significantly decrease prostate cancer mortality. This suggests that fish and fish oil may reduce the progression of benign prostate tumors into more aggressive forms of prostate cancer.

The authors concluded: “If other researchers confirm these results, the promotion of the Mediterranean dietary pattern might be an efficient way of reducing the risk of developing advanced prostate cancer. Dietary recommendations should consider whole patterns instead of focusing on individual foods.”

Of the 3 diets above, the Mediterranean Diet certainly seems to be the best diet to prevent prostate cancer.

What Does The American Cancer Society Say About Diet And Prostate Cancer?

 

best diet to prevent prostate cancer american cancer societyBased on the best available data, the American Cancer Society has made some very specific recommendations for reducing the risk of prostate cancer. They are:

#1: Control Weight.

#2: Be More Active.

#3: Eat Healthy. By that they mean:

Choose foods and drinks in amounts that help you get to and maintain a healthy weight.

  • Read food labels to become more aware of portion sizes and calories. Be aware that “low-fat” or “non-fat” does not necessarily mean “low-calorie.”
  • Eat smaller portions when eating high-calorie foods.
  • Choose vegetables, whole fruit, legumes such as peas and beans, and other low-calorie foods instead of calorie-dense foods such as French fries, potato chips and other chips, ice cream, donuts, and other sweets.
  • Limit your intake of sugar-sweetened beverages such as soft drinks, sports drinks, and fruit-flavored drinks.
  • When you eat away from home, be especially mindful to choose food low in calories, fat, and added sugar, and avoid eating large portion sizes.

Limit how much processed meat and red meat you eat.

  • Minimize your intake of processed meats such as bacon, sausage, lunch meats, and hot dogs.
  • Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).

Eat at least 2½ cups of vegetables and fruits each day.

  • Include vegetables and fruits at every meal and snack.
  • Eat a variety of vegetables and fruits each day.
  • Emphasize whole fruits and vegetables; choose 100% juice if you drink vegetable or fruit juices.
  • Limit your use of creamy sauces, dressings, and dips with fruits and vegetables.

Choose whole grains instead of refined grain products.

  • Choose whole-grain breads, pasta, and cereals (such as barley and oats) instead of breads, cereals, and pasta made from refined grains, and brown rice instead of white rice.
  • Limit your intake of refined carbohydrate foods, including pastries, candy, sugar-sweetened breakfast cereals, and other high-sugar foods.

While these recommendations focus on foods rather than diets, they sound a lot like the Mediterranean diet. The only thing that is missing from the American Cancer Society recommendations is olives and olive oil.

Final Thoughts

The American Cancer Society and this study agree that red and processed meats should be minimized in our diet. There is evidence from previous studies that both increase the risk of developing aggressive prostate cancer. The American Cancer Society replaces red and processed meat with fish and poultry. The Mediterranean diet replaces them with fish and legumes. I would be leery of any diet that places a heavy emphasis on red meat consumption.

Don’t think these dietary recommendations are just important for men. In a previous study the same authors reported that adherence to a Western diet increased the risk of developing breast cancer and adherence to the Mediterranean diet reduced risk. In addition, previous studies suggest that red meat consumption also increases the risk of breast cancer.

 

The Bottom Line:

 

A recent study looked at the effect of adherence to a Western Diet, a Prudent Diet, and a Mediterranean diet on the risk of developing aggressive prostate cancer. The study found:

  • High adherence to the Western diet tended to increase the risk of aggressive prostate cancer.
  • High adherence to the Prudent diet had no effect on aggressive prostate cancer risk.
  • High adherence to the Mediterranean diet decrease the risk of aggressive prostate cancer between 32% and 51% depending on the assay used to identify aggressive tumors.
  • Based on their study and previous studies, the authors suggested that fish and fish oil may reduce the progression of benign prostate tumors into more aggressive forms of prostate cancer.

The authors concluded: “If other researchers confirm these results, the promotion of the Mediterranean dietary pattern might be an efficient way of reducing the risk of developing advanced prostate cancer. Dietary recommendations should consider whole patterns instead of focusing on individual foods.”

The authors have also reported similar results for the effects of these 3 diets on the risk of developing breast cancer in women.

For the American Cancer Society recommendations on reducing prostate cancer risk and other details, read the article above:

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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