New Spanish study.
Included "754 histologically confirmed incident cases of prostate cancer and 1277 controls" from "7 Spanish provinces between September 2008 and December 2013."
Men were classified as enjoying one of the following diets: "Western, Prudent and Mediterranean". These were "previously identified dietary patterns".
Two terms were defined in an earlier study [2]:
"Participants were classified a posteriori into two major dietary patterns according to 14 items data using a cluster analysis. The cluster labelled “prudent dietary pattern” included daily intake of fruits, vegetables and low-fat dairy products, three or more servings a week of fish and two or more servings a week of legumes ... The cluster labelled “western dietary pattern” included daily intake of sugar, daily alcohol, consumption of red meat and processed meat products (more than two servings a week of each one) and cakes, pastries and other in baked goods with added sugar more than once a week ... Daily consumption of olive oil and salt were closely related in the two dietary patterns. Furthermore, consumption of eggs (more than 3 units a week), nuts (two or more servings a week) and crisps or other snacks more than once a week were excluded from both dietary patterns. Loading factors of food across these major food patterns are presented in table I." Oddly, "Mediterranean" was not defined.
Try again - from another earlier study [3]:
"The first component – labeled Western pattern – was characterised by high intakes of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks and other convenience food and sauces and by low intakes of low-fat dairy products and whole grains. The second component – named Prudent pattern – denoted high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices. The third component – the Mediterranean pattern – loaded high in fish, vegetables, legumes, boiled potatoes, fruits, olives and vegetable oil, and low in juices."
Rough generalizations do appear in the new paper:
"Prudent pattern, which combines vegetables and fruits with low fat dairy products, whole grains and juices."
"Mediterranean dietary pattern -rich in fruits and vegetables, but also in fish, legumes and olive oil"
But nothing for "Western".
Anyway, by now you will think you know what the men were eating. LOL.
"High adherence to Mediterranean dietary pattern ... was specifically associated to lower risk of prostate cancer with Gleason score >6: ... or with higher clinical stage ... This association was not observed with Prudent pattern .... Western pattern did not show any association with prostate cancer risk."
A third less risk of Gleason 7-10 & half the risk of clinical stage cT2b-T4!
...
Way back, when Dr. Myers was first touting the Med diet for PCa, I was puzzled. He is a man who will disregard 100 studies of a supplement if he doesn't see one that meets his high standard of study design. But there are no PCa-Med studies.
Things became clearer when he revealed that his first priority with new cases was to lower the risk of cardiovascular events. He was on solid ground because of cardio-Med diet studies. But I wondered if a 40% fat diet where olive oil dominated was really good for PCa. Was oleic acid PCa-benign?
Yet, men with PCa do have a higher risk of CVD mortality. Personally, I regard PCa largely as a metabolic disease, & the association with CVD as non-coincidental.
Seems from this study that Myers got it right.
(Alas, once again, an observation study without a vegetarian arm.)
A quibble: "the Mediterranean pattern – loaded high in fish". Some definitions specify moderate amounts of fish. (Other pre-formed protein sources are low or infrequent.)
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/288...
J Urol. 2017 Aug 22. pii: S0022-5347(17)77385-5. doi: 10.1016/j.juro.2017.08.087. [Epub ahead of print]
Mediterranean dietary pattern is associated to low risk of aggressive prostate cancer: MCC-Spain study.
Castelló A1, Boldo E2, Amiano P3, Castaño-Vinyals G4, Aragonés N2, Gómez-Acebo I5, Peiró R6, Jimenez-Moleón JJ7, Alguacil J8, Tardón A9, Cecchini L10, Lope V2, Dierssen-Sotos T5, Mengual L11, Kogevinas M4, Pollán M2, Pérez-Gómez B2; MCC-Spain researchers.
Author information
Abstract
PURPOSE:
To explore the association of the previously described Western, Prudent and Mediterranean dietary patterns with prostate cancer risk by tumor aggressiveness and extension.
METHODS:
MCC-Spain is a population-based multicase-control study, carried out in 7 Spanish provinces between September 2008 and December 2013. It collected anthropometric, epidemiologic and dietary information on 754 histologically confirmed incident cases of prostate cancer and 1277 controls aged 38 to 85 years. Three previously identified dietary patterns -Western, Prudent and Mediterranean- were reconstructed using MCC-Spain data. The association between each pattern and prostate cancer risk was assessed using logistic regression models with random province-specific intercepts. Risk according to tumor aggressiveness (Gleason score grade =6 vs >6) and extension (cT1-cT2a vs cT2b-cT4) was evaluated with multinomial regression models.
RESULTS:
High adherence to Mediterranean dietary pattern -rich in fruits and vegetables, but also in fish, legumes and olive oil- was specifically associated to lower risk of prostate cancer with Gleason score >6: RRRQuartile3(Q3)vsQuartile1(Q1)=0.66; 95%CI:0.46-0.96 and RRRQuartile4(Q4)vsQuartile1=0.68;95%CI:0.46-1.01;p-trend=0.023) or with higher clinical stage (cT2b-T4: RRRQuartile4vsQuartile1=0.49; 95%CI:0.25-0.96; p-trend=0.024). This association was not observed with Prudent pattern, which combines vegetables and fruits with low fat dairy products, whole grains and juices. Western pattern did not show any association with prostate cancer risk.
CONCLUSIONS:
Nutritional recommendations for prostate cancer prevention should consider whole dietary patterns instead of individual foods. We found important differences between Mediterranean dietary pattern, which was associated to lower risk of aggressive prostate cancer, and Western and Prudent dietary patterns, that had no relationship with prostate cancer risk.
Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Mediterranean”; Western”; “Diet; “Principal Component Analysis”; “Prostatic Neoplasms”; “prevention and control”
PMID: 28842246 DOI: 10.1016/j.juro.2017.08.087
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