Animal products, calcium and protein and prostate cancer risk in the Netherlands Cohort Study

Schuurman, A.G.; Brandt, Piet A. van den; Dorant, E.; Goldbohm, R. Alexandra

doi:10.1038/sj.bjc.6690472

Cited by 161 publications

(144 citation statements)

References 36 publications

(75 reference statements)

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“…In the present study, we also conducted a comparable analysis to explore individual nutrient values and prostate cancer risk adjusted for the same confounders as the dietary patterns (Table VI). Similar to other studies, 56,57 we did not find any statistically significant and clear associations between estimates of nutrient intake and prostate cancer risk. Further, the magnitude of risk for nutrients is generally lower than that for dietary patterns.…”

Section: Discussionsupporting

confidence: 90%

Dietary patterns and risk of prostate cancer in Ontario, Canada

Walker

Aronson

King

et al. 2005

Intl Journal of Cancer

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Dietary patterns reflect combinations of dietary exposures, and here we examine these in relation to prostate cancer risk. In a case-control study, 80 incident primary prostate cancer cases and 334 urology clinic controls were enrolled from 1997 through 1999 in Kingston, Ontario, Canada. Food-frequency questionnaires were completed prior to diagnosis and assessed intake in the 1-year period 2-3 years prior to enrollment. Among controls, dietary intake was used in principal components analyses to identify patterns that were then evaluated with all subjects in relation to prostate cancer risk using unconditional logistic regression, controlling for age. Prostate cancer is one of the most common cancer types in developed countries, with an estimated 20,100 new cases in 2004 in Canada. 1 Higher incidence rates occur in North America, Great Britain, Western Europe and Australia than in Asia, Latin America and Africa. 2 While genetic susceptibility is an established risk factor for prostate cancer, 2-5 the wide international variation in incidence points primarily to an environmental etiology. 6,7 The role of diet has been investigated in several epidemiologic studies, including dietary fat intake, vitamin A, carotenoids, fruits, vegetables, dairy products and soy products. 2,3,[7][8][9][10][11][12][13][14][15][16] The most consistent dietary component associated with prostate cancer risk is fat intake, 2 an association that is apparent despite differences in the quality of the study methods and assessment of dietary intake. [2][3][4]7,8,16 Recent attention has turned to a group of phytochemicals, particularly the isoflavones found in soybeans, 10,15 since Asians, with lower prostate cancer rates, have high consumption of soy products. Hypotheses regarding exposure to cadmium from foods such as shellfish and the risk of prostate cancer have not been substantiated by epidemiologic investigations. 2 Epidemiologic evidence supports an association between dietary factors and the risk of prostate cancer, but there are few consistent findings at a specific level. This is due in part to differences in measures of dietary intake, lack of variability in nutrient intakes among the population being studied and lack of control in the analysis for several possible confounders, including energy intake and lifestyle factors such as physical activity and smoking. 2,17,18 Further, potential associations between diet and prostate cancer risk may be concealed or lost when individual food items or nutrients are analyzed for their association with risk, as opposed to looking at groupings of habitually consumed foods. The metabolic and physiologic effects of combinations of foods on total risk are also unaccounted for when the conventional method of nutrient or individual food item analysis is used. 19 A broader consideration of patterns of food use may provide a more comprehensive assessment of the role of dietary factors on prostate cancer risk, given that foods are generally eaten in combination and together may have a greater impact on...

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Section: Discussionsupporting

confidence: 90%

Dietary patterns and risk of prostate cancer in Ontario, Canada

Walker

Aronson

King

et al. 2005

Intl Journal of Cancer

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“…The effects of protein and especially dairy protein on IGF-I could be important, because high serum IGF-I levels have been associated with a moderately increased risk of prostate cancer in several large-scale prospective studies including EPIC (Renehan et al, 2004;Allen et al, 2007). However, few studies have reported on protein intake in relation to risk (Severson et al, 1989;Schuurman et al, 1999;Chan et al, 2000), and, to our knowledge, this is the first study to examine specifically the association of dairy protein in risk. An alternative hypothesis is that dairy products may increase prostate cancer risk via their high calcium content, and our finding of a positive association with calcium intake is consistent with some (Chan et al, 2001;Gao et al, 2005;Tseng et al, 2005;Giovannucci et al, 2006;Kesse et al, 2006;Ahn et al, 2007;Mitrou et al, 2007), but not all, prospective studies (Koh et al, 2006;Severi et al, 2006;Rohrmann et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition

et al. 2008

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We examined consumption of animal foods, protein and calcium in relation to risk of prostate cancer among 142 251 men in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by recruitment centre and adjusted for height, weight, education, marital status and energy intake. After an average of 8.7 years of follow-up, there were 2727 incident cases of prostate cancer, of which 1131 were known to be localised and 541 advanced-stage disease. A high intake of dairy protein was associated with an increased risk, with a hazard ratio for the top versus the bottom fifth of intake of 1.22 (95% confidence interval (CI): 1.07 -1.41, P trend ¼ 0.02). After calibration to allow for measurement error, we estimated that a 35-g day À1 increase in consumption of dairy protein was associated with an increase in the risk of prostate cancer of 32% (95% CI: 1 -72%, P trend ¼ 0.04). Calcium from dairy products was also positively associated with risk, but not calcium from other foods. The results support the hypothesis that a high intake of protein or calcium from dairy products may increase the risk for prostate cancer.

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“…While some large cohort studies (with 4500 cases) have reported significant positive associations between dairy products and/or calcium intake and risk Chan et al, 2001), others have not (Schuurman et al, 1999;Michaud et al, 2001;Rodriguez et al, 2003). A recent clinical trial of calcium supplementation (1200 mg day À1 ) in the prevention of colorectal adenomas found no significant increase in prostate cancer (70 cases) risk with supplementation in secondary analyses, and even a suggestion of a protective effect (Baron et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Initially, we adjusted for age (in continuous years) only, but later for the following potential confounders: body mass index (o22.5, 22.5 -o25.0, 25.0 -o27.5, or X27.5 kg m À2 ), physical activity (o1000, 1000 -2499, or X2500 kcal week À1 ), smoking (never, past, or current), total energy intake (in quartiles), alcohol intake (none, 1 -3, 4 -6, or Xseven drinks week À1 ), red meat intake (pthree servings month, 1 -2 servings week, or Xthree servings week À1 ), vegetable intake (psix servings week, 1 -2 servings day, or Xthree servings day À1 ), and paternal history of prostate cancer (no or yes). We repeated the above analyses, examining only fatal prostate cancer, owing to the suggestion from some previous studies that the association may be stronger with advanced or fatal prostate cancer Schuurman et al, 1999;Chan et al, 2001;Rodriguez et al, 2003).…”

Section: Data Analysesmentioning

confidence: 99%

Dairy products, calcium and prostate cancer risk

et al. 2006

Br J Cancer

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In a prospective study of 10 011 men with 815 prostate cancer cases, despite plausible biological mechanisms, neither increasing intake levels of dairy products nor calcium from dairy products (P trend; 0.23 and 0.64, respectively), or calcium supplements was associated with prostate cancer risk (relative risk, 1.05; 95% confidence interval, 0.84 -1.31). (Gronberg, 2003). Although its incidence is increasing steadily in almost all countries, few modifiable predictors for the disease have been identified (Gronberg, 2003). Well-established risk factors, such as age, family history, race, and country of residence, are not amenable to modification and have limited utility as primary prevention strategies.Calcium intake, a modifiable dietary factor, has recently been proposed as a risk factor for prostate cancer. Evidence from in vitro and animal studies suggests that risk may be increased by higher levels of calcium, since these suppress 1,25-dihydroxyvitamin D 3 , the most active form of vitamin D 3 , that inhibits the proliferation of prostate cancer cells and promotes their differentiation (Schwartz et al, 1995(Schwartz et al, , 1997Giovannucci, 1998). However, relevant studies have yielded inconsistent results (Gao et al, 2005), although few studies have considered intake from calcium supplementation, that can provide higher doses than dietary intake. Given calcium's importance in the prevention of diseases such as osteoporosis, we conducted a study of the question in a large cohort of men. MATERIALS AND METHODS SubjectsThe Harvard Alumni Health Study, initiated in the 1960s, is an ongoing cohort study of men who entered Harvard University, United States, as undergraduates between 1916 and 1950. Health information is obtained from subjects via questionnaires mailed at periodic intervals. The present study utilises data from a questionnaire mailed in 1988 that included detailed information on diet, and eligible subjects were 12 805 men who responded. We excluded men reporting cancer at baseline (n ¼ 1731) and those not providing information on dairy product intake (n ¼ 60). Of the remaining 11 014 men, we successfully followed 10 011 (90.9%) for the development of prostate cancer; these men represent the subjects for the present analysis. Assessment of calcium intake and other factorsThe 1988 questionnaire assessed diet using an abbreviated version (23 food items) of a validated semiquantitative food frequency questionnaire (Willett et al, 1985(Willett et al, , 1987. Men indicated their usual daily intake of seven different dairy products (whole milk, low fat milk, cream, ice cream, yogurt, cheese and butter) using pre-specified responses ranging from 'almost never' to 'six or more times per day.' On the original, longer version of the questionnaire, 13 dairy items were assessed. However, we believe our assessment of calcium intake using the seven items s reasonably valid. While we did not directly validate our 7-item questionnaire against the longer questionnaire, a previous study that assessed fewer items -mil...

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Animal products, calcium and protein and prostate cancer risk in the Netherlands Cohort Study

Cited by 161 publications

References 36 publications

Dietary patterns and risk of prostate cancer in Ontario, Canada

Dietary patterns and risk of prostate cancer in Ontario, Canada

Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition

Dairy products, calcium and prostate cancer risk

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