Cohort study of diet, lifestyle, and prostate cancer in adventist men

Abstract

Dietary and lifestyle characteristics were evaluated in relation to subsequent prostatic cancer risk in a cohort of approximately 14,000 Seventh-day Adventist men who completed a detailed lifestyle questionnaire in 1976 and who were monitored for cancer incidence until the end of 1982. During the 6-year follow-up period, 180 histologically confirmed prostatic cancers were detected among some 78,000 man-years of follow-up. Increasing educational attainment was associated with significantly decreased risk of prostate cancer in this study; age at first marriage was also inversely associated with risk, although this was not significant. There was no relationship between body mass index (as measured by Quetelet's Index) and risk. A history of prostate '%rouble" was associated with a 60% increase in risk which was highly significant.Although there were suggestive relationships between increasing animal product consumption and increased risk, these results did not persist after accounting for the influence of fruit and vegetable consumption. Nor was exposure to the vegetarian lifestyle during the childhood years associated with alterations in subsequent risk. However, increasing consumption of beans, lentils and peas, tomatoes, raisin, dates, and other dried fruit were all associated with significantly decreased prostate cancer risk.Cancer 64:598-604, 1989.ANCER OF THE PROSTATE is the second most Corn-C mon malignancy among men in the United States, ranking only behind lung cancer. Among men, 20% of all newly diagnosed cancers are prostatic cancer and they comprise 1 1 % of all male cancer deaths. Incidence rates have been increasing during the last several decades.' Various factors have been investigated in regard to the etiology of this cancer including socioeconomic status, sexual activity, marital status, venereal disease, and race. The incidence rates for blacks in the United States are the highest recorded in the world. Dietary habits have also been related to this cancer by some investigators. Diets rich in animal fat appear to be associated with increased risk for prostatic cancer. In ecologic studies there is a strong positive correlation between dietary fat consumption and prostatic cancer incidence worldwide.* Within the US prostatic cancer mortality rates are highest in counties with the highest fat consumption.' Also, prostatic cancer is increasing in Japan which is experiencing From the Department of Preventive Medicine, Lorna Linda University increases in fat consumption. The migrant studies of Japanese (and Polish) in the US also support some of the hypotheses relating dietary practices common to the western diet to the etiology of prostate cancer.Previous studies among Seventh-day Adventist vegetarians have found lower rates for prostate cancer4 as compared to other white men in California. Fatal prostate cancer risk among Adventists has been associated with increasing milk consumption and over~eight.~ Hirayama has provided evidence that men who eat green and yellow vegetables on a daily basis have low...

Fruit and vegetable intake and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

“…Our non‐significant associations between several vegetable subtypes and risk of prostate cancer are in line with previous prospective studies which have also found no association between overall prostate cancer risk and cruciferous9, 12, 27 or leafy vegetable intake 8, 9, 28, 29. Also, although early reports linked frequent consumption of tomatoes, tomato products or lycopene (a carotenoid from tomatoes) with lower risk of overall prostate cancer,13, 25 our study and the latest meta‐analysis from WCRF/AICR did not support this association,3 and nor did findings from a pooled analysis of blood lycopene concentrations and overall prostate cancer risk (although there was statistically significant heterogeneity by stage of disease, and the odds ratios (ORs) for aggressive disease for the highest compared with the lowest fifth of lycopene was 0.65 (95% CI: 0.46, 0.91; p‐ trend = 0.032) 26. However, it should be highlighted that not all studies have divided fruit and vegetable intake in the same subtypes.…”

“…Only one24 out of the five5, 8, 9, 24, 25 studies that have assessed the association between citrus fruit and prostate cancer risk has also found a significant inverse association, and no association between circulating concentrations of the citrus biomarker β ‐cryptoxanthin and prostate cancer risk was observed in a pooled analysis of 10 prospective studies 26. Our non‐significant associations between several vegetable subtypes and risk of prostate cancer are in line with previous prospective studies which have also found no association between overall prostate cancer risk and cruciferous9, 12, 27 or leafy vegetable intake 8, 9, 28, 29.…”

Lycopene and prostate cancer

“…Moreover, of the seven studies that specifically examined whether dietary tomato products in particular reduce the risk of prostate cancer, only three found this to be the case. 5,84,85 One further is inconclusive statistically but tends to support that hypothesis 86 and three found no association at all. 73,87,88 However, one of the latter three negative studies 73 did describe a strong dietary association of decreased risk of prostate cancer with the consumption of tinned baked beans (RR ¼ 0.52; 95% confidence interval ¼ 0.31 -0.88) and the authors did suggest that tinned baked beans do provide a large amount of highly bioavailable lycopene.…”

Health Benefits of Nut Consumption

“…Old epidemiological evidence of the role of nut consumption on cancer incidence was inconclusive [57,58,59]. More recent reports support a preventive role, although limited to women [56,57,58,59]. A small case-control study in Greek women [60] suggests that a diet rich in nuts, seeds and pulses reduces the risk of endometrial cancer by 27% compared to infrequent consumption of such foods.…”